Racial Influences on Pediatric Tracheostomy Outcomes

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Romaine F Johnson1,2, Clarice M Brown3, Dylan R Beams1

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.

The Laryngoscope
|September 3, 2021
PubMed

Insights

Black children underwent disproportionately more tracheostomies and had higher comorbidity burdens. However, race did not impact neurocognitive disability, decannulation, or mortality rates after pediatric tracheostomy.

Area of Science:

  • Pediatric Surgery
  • Health Disparities
  • Otolaryngology

Background:

  • Race is a significant factor in healthcare disparities.
  • Understanding racial impacts on pediatric surgical outcomes is crucial.
  • Pediatric tracheostomy outcomes require examination across racial groups.

Purpose of the Study:

  • To determine if race influences outcomes following pediatric tracheostomy.
  • To compare neurocognition, mortality, and decannulation rates among different racial groups.

Main Methods:

  • Retrospective case series of 445 children undergoing tracheostomy from 2014-2019.
  • Children were grouped by race to analyze outcomes.
  • Statistical analysis controlled for age, sex, prematurity, and ventilator dependence.

Main Results:

  • Black children had a higher proportion of tracheostomies and greater comorbidity burden (e.g., lower birth weight, more extreme prematurity, higher rates of bronchopulmonary dysplasia).
  • Hispanic children had proportionally fewer tracheostomies compared to their representation in admissions.
  • No significant racial differences were observed in severe neurocognitive disability, decannulation rates, or mortality.

Conclusions:

  • Despite higher comorbidity burdens and disproportionate tracheostomy rates in Black children, long-term outcomes were similar across racial groups.
  • Health disparities by race may not alter long-term outcomes after pediatric tracheostomy.
  • This suggests race-independent factors may be more influential on long-term pediatric tracheostomy success.
Abstract

Keywords:
Pediatric tracheostomyracial disparitiestracheostomy outcomes

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