To evaluate inpatient outcomes associated with tracheostomy in pediatric patients diagnosed with tracheal stenosis using a large, multi-year administrative sample. Pediatric hospital discharges from the Kids' Inpatient Database (KID), 2003–2019. Patients aged ≤20 years with a diagnosis of tracheal stenosis who underwent tracheostomy were identified using validated ICD-9/10 codes. Primary outcomes included length of stay (LOS), total hospital charges, and in-hospital mortality. Descriptive statistics were stratified by age group and insurance status. Multivariable linear regression was used for log-transformed LOS and charges; logistic regression assessed predictors of mortality. A total of 1480 patients were included; 57. 9% were male and 77. 4% were infants. Median LOS was 51 days (IQR: 24–101), and median inflation-adjusted charges were 389, 221 (IQR: 170, 641–805, 264, 2019 USD). In-hospital mortality was 6. 6%. Infants had the longest total hospital LOS and highest charges. Medicaid patients had significantly longer LOS (p = 0. 011). On multivariable analysis, longer LOS was associated with infant age, female sex, and psychiatric or pulmonary comorbidities. Higher charges were associated with infants, adults, and patients with psychiatric or pulmonary conditions. Pulmonary circulatory disease was associated with increased odds of in-hospital mortality; no demographic or hospital-level variables were significant predictors. Children with tracheal stenosis undergoing tracheostomy experience prolonged hospitalizations and substantial inpatient charges. Infants and those with psychiatric or cardiopulmonary comorbidities are particularly vulnerable. These findings highlight the need for targeted care pathways to improve outcomes for this population. • First large-scale analysis of tracheostomy outcomes in pediatric tracheal stenosis • Infants had the longest hospital stays and highest inpatient charges • Pulmonary circulatory disease was linked to increased in-hospital mortality • Medicaid patients had significantly longer hospitalizations than privately insured • Psychiatric comorbidities among adolescents were associated with higher charges
Talwar et al. (Fri,) studied this question.