Hospital readmission and mortality after discharge with pediatric tracheostomy: A one-year population-based cohort study in Taiwan.

OBJECTIVE

To analyze hospital readmission and mortality rates within 1 year after discharge with pediatric tracheostomy.

METHODS

Data were obtained from Taiwan's National Health Insurance Research Database. All inpatients aged <18 years who underwent tracheostomy between 2001 and 2019 were identified using International Classification of Diseases codes. All-cause readmission and mortality rates at 30, 90, 180, 270, and 365 days after pediatric tracheostomy were calculated, and factors associated with readmission and mortality at 1 year after tracheostomy were analyzed.

RESULTS

A total of 1911 children who underwent tracheostomy were included. At 1 year after tracheostomy, 1485 (78 %) children experienced hospital readmission, and 273 (14 %) died. The accumulated readmission rates at 30, 90, 180, 270, and 365 days were 32 %, 56 %, 69 %, 74 %, and 78 %, respectively. The accumulated mortality rates at 30, 90, 180, 270, and 365 days were 2 %, 6 %, 9 %, 12 %, and 14 %, respectively. Children who experienced readmission within the 1-year follow-up period were significantly younger (8.3 vs 9.9 years) and less indicated for trauma or head injury (33 % vs 39 %), and they had longer intensive care unit stays (38 days vs 30 days) and hospital stays (62 days vs 51 days) than had those without readmission. Multivariable analysis revealed that infants (HR = 1.20, 95 % CI: 1.01 to 1.44) and toddlers (HR = 1.24, 95 % CI: 1.04 to 1.48) were at significantly greater risk of readmission than were adolescents during the 1-year follow-up period. Mortality risk within this period was significantly higher among infants, toddlers, preschoolers, and school-aged children than among adolescents.

CONCLUSION

Children at young ages are at greater risk of readmission and mortality following tracheostomy.