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Risk factor analysis for mortality among infants requiring tracheostomy
Author(s) -
Strang Abigail R.,
Briddell Jenna W.,
Barth Patrick C.,
Shah Udayan K.,
Chidekel Aaron
Publication year - 2018
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24064
Subject(s) - medicine , bronchopulmonary dysplasia , pediatrics , gestational age , subglottic stenosis , laryngomalacia , retrospective cohort study , mortality rate , birth weight , population , comorbidity , cohort , pregnancy , surgery , airway , stridor , genetics , environmental health , biology
Abstract Introduction An increasing number of tracheostomies are performed in infants with complex comorbidities including bronchopulmonary dysplasia (BPD) and congenital heart disease (CHD). With this shift in indications, there is an urgent need to characterize outcomes in this population. Methods This 5‐year retrospective chart review assessed rates of 12‐month mortality in infants who were ≤12 months of age at the time of tracheostomy at a tertiary care pediatric hospital and risk factors associated with death. Patient characteristics evaluated included chronologic age and post‐menstrual age at tracheostomy placement, gestational age and weight, sex, ethnicity, indication for tracheostomy, and comorbidities including BPD, CHD, subglottic stenosis (SGS), craniofacial syndromes, and chromosomal trisomy syndromes. Subgroup analysis was performed in infants with CHD. Results One hundred thirty‐two tracheostomies were performed during the study period with an overall 12‐month mortality of 14.4% (19/132). Mortality was increased in patients with CHD (35%) and decreased in patients with SGS (3.7%). No other patient characteristics were associated with differences in mortality. There was a trend towards improved mortality outcomes among patients born at earlier gestational ages. Conclusions Among infants with tracheostomy in this cohort, overall mortality rates were relatively low but not insignificant. CHD was associated with increased mortality; however, children with SGS showed more favorable outcomes. Other patient characteristics were not associated with differences in mortality. These data clarify outcomes in a group of infants with tracheostomy.