Abstract
BackgroundAccidental tracheostomy decannulation (ATD) is a life-threatening event in pediatric patients. The factors associated with ATD in children are largely unknown. Utilizing the National Surgical Quality Improvement Pediatric (NSQIP-P) dataset, we sought to identify the incidence of ATD and associated factors. MethodsPatients who underwent surgery at continuously enrolled American College of Surgeons NSQIP-P hospitals from January 1, 2012, to December 31, 2021, were included. Those who underwent a tracheostomy (CPT 31600 or 31601) as a primary or concurrent procedure were analyzed. ATD was defined by the NSQIP-P REINTUB variable. Multivariable logistic regression analysis and propensity score matching were performed to identify independent associations between demographic variables, relevant comorbidities, intraoperative factors, and ATD. Multivariable regression analyses were performed to identify any association between ATD and unplanned reoperation, pneumonia, extended length of stay, and death in 30 days in both pre-matched and matched cohorts. ResultsA total of 5229 patients undergoing tracheostomy were included in the final analysis for the pre-matched cohort. ATD occurred in 93 (1.8 %) patients, with 42 % (n = 39) of these cases occurring within the first two postoperative days. In the matched cohort, female gender (P = 0.002) and structural pulmonary/airway abnormality (P = 0.016) were independently associated with ATD. Additionally, ATD was associated with unplanned reoperation (P < 0.001) and pneumonia (P = 0.024). The pre-matched cohort showed consistent results with the matched cohort. DiscussionAccidental decannulation is a serious complication following pediatric tracheostomy. By identifying patients at higher risk for ATD and the timing of its occurrence, providers can employ measures targeting these patients during their highest risk period. The sequelae associated with ATD further emphasize the importance of preventing this complication.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: International Journal of Pediatric Otorhinolaryngology
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
