Risk factors associated with unplanned readmissions and frequent out-of-hour emergency department visits after pediatric tracheostomy: a nationwide inpatient database study in Japan

PMCID: PMC12170732

PMID: 40523996

DOI: 10.1007/s00431-025-06242-1

Journal: European journal of pediatrics

Publication Date: 2025-6-17

Authors: Ito-Shinjo A, Shinjo D, Nakamura T, Kubota M, Fushimi K

Key Points

• Pediatric tracheostomy patients under 1 year old have significantly higher risks of readmission and emergency department visits
• 43% of patients were readmitted within 180 days, with respiratory disorders accounting for 66% of readmissions
• Comprehensive discharge planning and specialized home care support are crucial for reducing medical resource utilization in complex pediatric cases

Summary

This nationwide retrospective study analyzed medical resource utilization among 1,112 Japanese children who underwent tracheostomy, revealing significant insights into readmission and emergency department (ED) visit patterns within 180 days post-procedure. The research identified critical risk factors associated with unplanned hospital readmissions and frequent out-of-hour ED visits, highlighting the complex medical needs of pediatric tracheostomy patients.

The study found that 43% of patients were readmitted, with respiratory disorders being the most common reason (54%). Key risk factors for readmission included age < 1 year (OR 1.77), tube feeding (OR 1.36), neurological impairment (OR 1.52), and mechanical ventilation (OR 1.43). Similarly, frequent ED visits were associated with age < 1 year, home oxygen therapy, and unplanned tracheostomy. These findings underscore the importance of comprehensive discharge planning, specialized home care support, and targeted follow-up strategies for medically complex pediatric patients.