Survival analysis and decannulation outcomes of infants with tracheotomies

Salley, Jordan R.; Kou, Yann Fuu; Shah, Gopi; Mitchell, Ron B.; Johnson, Romaine F.

doi:10.1002/lary.28297

Cited by 33 publications

(85 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This sample's 2.7 years implies that former preterm infants take a bit longer when compared to all pediatric cases. In contrast, our current sample's 27% decannulation was in line with previous research 15,23,24 …”

Section: Discussionsupporting

confidence: 92%

“…Research indicates that the survival of preterm and extremely preterm infants is increasing 9,14 . Research also shows that many of these children need tracheostomies until early childhood to allow time for the conditions that lead to the tracheostomy to resolve or improve 10,15 . Despite these concerns, the time it takes to decannulate and the survivors' QOL among preterm and extremely preterm infants with tracheostomy are understudied.…”

Section: Discussionmentioning

confidence: 99%

“…Research utilizing survival analysis to assess decannulation remains sparse, although it is well suited because decannulation can be skewed and often depends on the underlying reason for tracheostomy placement 23 . In a study of children of all ages examining ventilatory status as the main variable, the median decannulation time was 2.1 years 15 . Another study looking at children of all ages showed a median decannulation time of 2.6 years.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

A Longitudinal Analysis of Outcomes in Tracheostomy Placement Among Preterm Infants

et al. 2020

Self Cite

View full text Add to dashboard Cite

Objectives To study a case series of preterm and extremely preterm infants, comparing their decannulation and survival rates after tracheostomy. Methods We performed a single‐institution longitudinal study of preterm infants with a tracheostomy. Infants were categorized as premature (born > 28 weeks and < 37 weeks) and extremely premature (born ≤ 28 weeks). Decannulation and survival rates were determined using the Kaplan–Meier method. Neurocognitive quality of life (QOL) was reported as normal, mild/moderately, and severely impaired. Statistical significance was set at P < .05. Results This study included 240 patients. Of those, 111 were premature and 129 were extremely preterm. The median age (interquartile range) at tracheostomy was 4.8 months (0.4). Premature infants were more likely than extremely preterm to have airway obstruction (54% vs. 32%, P < .001); whereas extremely preterm infants were more likely to have bronchopulmonary dysplasia (68% vs. 15%, P < .001) and to be ventilation‐dependent (68% vs. 54%, P < .001). The 5‐year decannulation rate for premature infants was 46% and for extremely preterm was 64%. The 5‐year survival rate post‐tracheostomy for preterm was 79% and for extremely preterm was 73%. The log‐rank test of equality showed that decannulation and survival were similar (P > .05) for both groups, even after controlling for potentially confounding factors like race, age, gender, birth weight, and age at tracheostomy. For neurocognitive QOL, 47% of patients survived with severely impaired QOL after tracheostomy. Preterm had 56% with severely impaired QOL and extremely preterm had 40% with severely impaired QOL (P = .03). Conclusion This study demonstrated that the time to decannulation and the likelihood of survival did not vary among premature and extremely premature infants even when controlling for other confounding variables. Level of Evidence 3b Laryngoscope, 131:417–422, 2021

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Longitudinal Analysis of Outcomes in Tracheostomy Placement Among Preterm Infants

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…Airway obstruction, respiratory failure, and pulmonary toileting are the most common indications for tracheostomy. [10][11][12] Black children with tracheostomies were identified to more likely be diagnosed with laryngeal stenosis, BPD and laryngeal stenosis and to have an extended length of stay (P \ .001). One pediatric institution identified ventilator-associated respiratory failure followed by airway anomalies (such as subglottic or tracheal stenosis, tracheomalacia, or BPD), airway obstruction, and vocal cord paralysis as the most common diagnoses associated with performing a tracheostomy.…”

Section: Resultsmentioning

confidence: 99%

The Incidence of Pediatric Tracheostomy and Its Association Among Black Children

Brown

Shah

Mitchell

et al. 2020

Otolaryngol.--head neck surg.

Self Cite

View full text Add to dashboard Cite

Objective In 2012, Black or African American children constituted 21% of pediatric tracheostomies while representing approximately 15% of the US population. It is unclear if this discrepancy is due to differences in associated diagnoses. This study aimed to analyze the incidence of pediatric tracheostomy in the United States from 2003 to 2016 and to determine the odds of placement among Black children when compared with other children. Study Design Retrospective. Setting Academic hospital. Subjects and Methods We used the 2003 to 2016 Kid Inpatient Database to determine the incidence of pediatric tracheostomy in the United States and determine the odds of tracheostomy placement in Black children when compared with other children. Results A total of 26,034 pediatric tracheostomies were performed between 2003 and 2016, among which, 21% were Black children. The median age was 7 years (interquartile range [IQR] = 0 to 17); 43% were ≤2 years old, and 62% were male. The most common principal diagnosis was respiratory failure (72%). When compared with other children, Black children were more likely to undergo tracheostomy (odds ratio [OR] = 1.2; 95% CI, 1.1-1.3), which increased among children younger than 2 years old (OR = 1.5; 95% CI, 1.4-1.5). Black children with tracheostomies were also more likely to be diagnosed with laryngeal stenosis and bronchopulmonary dysplasia and to have an extended length of stay ( P < .001). Conclusion Black children are 1.2 times more likely to undergo tracheostomy in the United States compared with other children. Further investigation is warranted to evaluate if there are underlying anatomical, environmental, or psychosocial factors that contribute to this discrepancy.

show abstract

“…However, there are few studies on the decannulation of children who were tracheotomized in infancy, which is defined as the period between birth and 3 years of age [5][6] [6].…”

Section: Introductionmentioning

confidence: 99%

Age at Decannulation after Pediatric Tracheostomy.

2020

jecor

View full text Add to dashboard Cite

Background: Parents of tracheostomized infants often enquire when their children will undergo decannulation. However, there are few studies on the decannulation of children who are tracheotomized in infancy. Therefore, this study investigated when decannulation should be performed in children by retrospectively analysing medical records. Methods: We performed a retrospective chart review of tracheostomy, decannulation and tracheostoma closure in 48 children who underwent tracheostomy before the age of 3 years. The indications for tracheostomy included upper airway obstruction, neurological conditions, cardiopulmonary conditions, craniofacial conditions and trauma. Result: Nineteen (33.3%) patients were decannulated during the follow-up period: 12 had upper airway obstruction, four had cardiopulmonary conditions, one had a neurological condition and two had craniofacial conditions. The average age at tracheostomy was 13.6 months. The average age at the start of the decannulation therapy was 5.4 years. The average age at decannulation was 7.2 years. The average age at tracheostoma closure was 9.2 years. Conclusion: This description of ages at decannulation after pediatric tracheostomy may be useful when explaining the prognoses and timelines of decannulation to parents and caretakers of pediatric patients who need to undergo tracheostomy.

show abstract

Survival analysis and decannulation outcomes of infants with tracheotomies

Cited by 33 publications

References 27 publications

A Longitudinal Analysis of Outcomes in Tracheostomy Placement Among Preterm Infants

A Longitudinal Analysis of Outcomes in Tracheostomy Placement Among Preterm Infants

The Incidence of Pediatric Tracheostomy and Its Association Among Black Children

Age at Decannulation after Pediatric Tracheostomy.

Contact Info

Product

Resources

About