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Scientific Oral Presentations

Care Equity, Quality, and Safety

Session: Scientific Oral Presentation 2 - Care Equity, Quality and Safety

Identifying At-Risk Patient Populations For Elevated Healthcare Burden After Tracheotomy: Implications for Quality Improvement

Monday, October 13, 2025

8:24 AM - 8:30 AM EDT

Location: 107-108

Disclosure(s):

Jennifer A. Kong, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Hrithik Praveen:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Ina A. Lee, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: This study aims to identify medical and socioeconomic factors that drive an increased in-hospital, early post-discharge, and extended post-discharge healthcare utilization in children who underwent tracheotomy.

Methods: Retrospective single-institution study of children receiving care with a tracheotomy, May 2017-March 2024. Chart review characterized demographic data, payor, and medical decision making. Outcomes of tracheotomy size/brand/style change, readmission to hospital/ED visit, and decannulation status were analyzed using univariate and multivariable logistic regression models.

Results: Of 143 patients identified (mean age = 6.3 years, 72.3% white, 33.6% female), 73.4% had public insurance, 26.6% private insurance, and the rest self-pay. DCS involvement (13.2% of patients) was not associated with readmission to hospital/ED visit within 30 days of discharge (aOR =1.072; 95% CI: 0.307-3.743). Respiratory comorbidities were associated with having at least one tracheostomy size/brand/style change in the first 30 days of tracheotomy (aOR =2.733, 95% CI: 1.120-6.671). Craniofacial abnormalities (aOR =0.868, 95% CI: 0.236-3.189) and neurological comorbidities (aOR =1.426, 95% CI: 0.645-3.153) were not associated with having at least one tracheotomy size/brand/style change in the first 30 days of tracheotomy. Children who received a tracheotomy for pulmonary toilet were less likely to be decannulated (aOR =0.019, 95% CI: 0.001-0.490). Other tracheotomy indications such as prolonged ventilatory support (aOR =0.356, 95% CI: 0.074-1.707) and upper airway obstruction (aOR =0.350, 95% CI: 0.070-1.744) were not associated with decannulation status.

Conclusions: Demographic data were not associated with outcomes. Of analyzed medical conditions, respiratory comorbidities are associated with increased tracheostomy size/brand/style change within 30 days of tracheotomy. Of tracheotomy indications, pulmonary toilet was associated with poorer decannulation rates. Results suggest preventative measures to reduce healthcare burden for patients and institutions.

Presenting Author(s)

Jennifer A. Kong, BA

Medical Student
Vanderbilt University School of Medicine
Nashville, TN, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

HP

Hrithik Praveen, BS

Medical Student (Rising 4th Year)
Vanderbilt University Medical Center
Nashville, Tennessee, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Ina A. Lee, MS

Medical Student
Vanderbilt School of Medicine
Nashville, TN, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Kalpnaben R. patel, CCRP

Clinical Translational Research Coordinator
Vanderbilt University Medical Center Department of Pediatric Otolaryngology - Head and Neck Surgery
Franklin, TN, United States

Disclosure information not submitted.

Senior Author(s)

Christopher T. Wootten, MD, MMHC

Professor, Department of Otolaryngology--Head and Neck Surgery
Vanderbilt Medical Center
Nashville, TN, United States

Disclosure information not submitted.