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Mortality associated with tracheostomy complications in the United States: 2007–2016
Author(s) -
Cramer John D.,
Graboyes Evan M.,
Brenner Michael J.
Publication year - 2019
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27500
Subject(s) - medicine , odds ratio , confidence interval , complication , pediatrics , retrospective cohort study , mortality rate , cause of death , young adult , surgery , disease
Objectives/Hypothesis To investigate patterns of tracheostomy‐associated death in the United States. Study Design Retrospective database review. Methods We used Multiple Cause‐of‐Death data from the Centers for Disease Control and Prevention to determine cumulative national mortality associated with tracheostomy complications in the United States from 2007 to 2016. Using International Classification of Diseases, Tenth Revision data, we investigated how frequently tracheostomy‐related complications were reported in cause of death data. We then compared the characteristics of patients with tracheostomy‐related mortality to patients reported to have died of other causes. Results Over the 10‐year period studied, we identified 623 tracheostomy‐related deaths (537 adults and 86 children) out of 25,587,306 total deaths reported. Although absolute mortality was higher in adults, the reported base rate of tracheostomy complication–associated mortality was tenfold higher in children. Most tracheostomy‐related deaths occurred in a hospital facility (74.5% in adults). Deaths associated with tracheostomy complications were significantly more common for African American children (odds ratio [OR]: 2.02, 95% confidence interval [CI]: 1.26‐3.24) and adults (OR: 1.59, 95% CI: 1.29‐1.96) or in Hispanic adults (OR: 1.42, 95% CI: 1.06‐1.89). Deaths related to a tracheostomy complication more commonly occurred on the weekend (OR: 1.24, 95% CI: 1.04‐1.49) and in the most recent 2‐year period (OR: 1.31, 95% CI: 1.03‐1.68). Adults with a bachelor's, master's or doctorate degree were significantly less likely to have mortality associated with a tracheostomy‐related complication (OR: 0.54, 95% CI: 0.39‐0.75). Conclusions Tracheostomy‐related complications were implicated in the deaths of a significant number of individuals. Several demographic groups had increased likelihood of tracheostomy‐related mortality. Future research is necessary to develop targeted interventions to decrease harm. Level of Evidence NA Laryngoscope , 129:619–626, 2019