Impact of Language and Ethnicity on Pediatric Tracheostomy Outcomes

Objective: To compare outcomes after tracheostomy between children from Spanish- and English-speaking families. Study Design: Prospective cohort study. Setting: Tertiary care children’s hospital. Methods: All children <18 years of age who had a tracheostomy placed between 2014 and 2020 were included. Comorbidities and postsurgical outcomes were compared between (1) children whose families preferred speaking Spanish or identified as Hispanic/Latino and (2) children from English-language or non-Hispanic families. Results: A total of 339 children met inclusion, with 11% (37/339) from families identifying Spanish as their primary language and 33% (112/339) identifying as Hispanic. Spanish-speaking families were more likely to have tracheostomy-dependent children with cardiac conditions (65% vs 42%, P =.008) and high complexity (72% vs 49%, P =.007). Outcomes were similar regardless of language preference, with 45% (153/339) still tracheostomy dependent, 28% (94/339) decannulated, and 6.8% (23/339) deceased at a median follow-up of 1.77 years (interquartile range, 0.65-3.43). Severe neurocognitive disabilities were similar between Spanish- and English-language families (P >.05). Spanish language was not associated with times to decannulation or death in univariate or multiple regression models. A sensitivity analysis of self-identified Hispanic or Latino patients did not show significant differences for time to decannulation, death, or neurocognitive disability rates (P >.05). Conclusion: Spanish language and Hispanic ethnicity appear to have minimal impact on pediatric tracheostomy outcomes.