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Emergency Department Visits and Hospitalizations After Pediatric Tracheostomy

Dylan R Beams1, Stephen R Chorney1,2, Yann-Fuu Kou1,2

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

The Laryngoscope
|September 30, 2022
PubMed

Insights

Nearly half of children with tracheostomies have frequent emergency department visits and hospitalizations. Black race, mechanical ventilation, and Spanish language are associated with higher utilization rates.

Area of Science:

  • Pediatric Medicine
  • Respiratory Care
  • Healthcare Disparities

Background:

  • Pediatric tracheostomy is a critical intervention for managing complex respiratory conditions.
  • High utilization of emergency department (ED) and hospital services post-tracheostomy can strain resources and impact patient outcomes.

Purpose of the Study:

  • To identify risk factors associated with frequent ED visits and hospitalizations in children following tracheostomy.
  • To inform targeted interventions for reducing healthcare utilization in this vulnerable population.

Main Methods:

  • A prospective cohort study followed 239 children under 18 years for 24 months after tracheostomy placement.
  • Data on ED visits and hospitalizations were collected to identify predictors of frequent utilization (≥4 visits).

Main Results:

  • 47% of children experienced frequent ED visits/hospitalizations, totaling 1285 encounters.
  • Respiratory illness (54%) and gastrostomy tube issues (9.3%) were primary reasons for visits.
  • Frequent utilization was linked to Black race (OR: 2.01), mechanical ventilation (OR: 2.74), and Spanish language (OR: 3.86).
  • Hispanic ethnicity and gestational age predicted respiratory failure visits.

Conclusions:

  • Frequent healthcare utilization is common in children post-tracheostomy, with significant contributing factors identified.
  • Interventions addressing respiratory issues and supporting specific demographic groups may reduce hospital readmissions.
  • While tracheostomy-related complications are infrequent, managing respiratory illness is key to decreasing overall healthcare burden.
Abstract

Keywords:
patient safetypediatric tracheostomyquality improvementreadmissions

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