Areas for Quality Improvement for Airway Dilation in Children: NSQIP-Pediatric 30-Day Outcomes.

Journal Article (Journal Article)

Objective To identify predictors of adverse events and highlight areas for quality improvement for children who underwent laryngeal or tracheal dilation, without prior tracheostomy placement. Study Design Cross-sectional analysis using a US national database. Setting American College of Surgeons (ACS) National Surgical Quality Improvement Program (ACS NSQIP-pediatric), years 2012 to 2015. Subjects and Methods Patients 18 years and younger were included. Patients without prior tracheostomy placement were identified using 2017 Current Procedural Terminology ( CPT) codes: 31528, 31529, and 31630. Results We identified a total of 160 children who met inclusion criteria. Forty-three (26.9%) patients experienced an adverse event. Mortality was observed postoperatively in 1 patient (0.6%) 1 day after the operation. Younger age, increased number of days from hospital admission to operation, and increased number of days from operation to discharge were noted to be associated with adverse events. Last, the risk of adverse events appears to be mitigated by concurrent other laryngeal procedures. Conclusions There is a high rate of adverse events reported with airway dilation in children. Unplanned reoperations and hospital readmissions are highlighted areas for quality improvement. Airway dilation in children appears to avoid tracheostomy and open laryngotracheoplasty in most cases for at least 30 days postoperatively. Further investigation may be helpful to understand if younger age and delayed operative intervention contribute to increased adverse events.

Full Text

Duke Authors

Cited Authors

  • Cheng, J; Liu, B; Farjat, AE

Published Date

  • June 2018

Published In

Volume / Issue

  • 158 / 6

Start / End Page

  • 1119 - 1126

PubMed ID

  • 29405845

Pubmed Central ID

  • PMC6825496

Electronic International Standard Serial Number (EISSN)

  • 1097-6817

Digital Object Identifier (DOI)

  • 10.1177/0194599818756590


  • eng

Conference Location

  • England