Wednesday, February 10, 2021

Comparing Long‐Term Outcomes in Tracheostomy Placed in the First Year of Life

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Objectives//Hypothesis

To characterize long‐term outcomes in pediatric patients requiring tracheotomy in the first year of life.

Study Design

Retrospective case series.

Methods

A retrospective longitudinal registry of tracheostomy patients was queried for patients who underwent tracheotomy from birth to 11 months. Primary outcomes were decannulation and survival. Secondary outcomes included neurocognitive quality of life assessed with the PedsQL Family Impact Module (scored from worst to best, 0 to 100 points).

Results

The study included 337 children. Thirty (8.90%) were neonates and 307 (91.10%) were infants. The population was 56.08% male (n = 189), and the racial and ethnicity composition were equally distributed (29.97% White, 31.45% Black, and 31.16% Hispanic). Significant differences between neonates and postneonates included birth weight in grams (2,731.40 vs. 1,950.44, P < .05), extreme prematurity (13.33% vs. 38.88%, P = .01), upper airway obstruction (80.00% vs. 42.67%, P < .05), and the need for mechanical ventilation (40.00% vs. 83.71%, P < .05). Despite these differences, long‐term outcomes were similar: decannulation (X 2 = 2.19, P = .14), death (X 2 = 2.63, P = .11), and neurocognitive quality of life (X 2 = 2.63, P = .27). Having a child with a tracheostomy caused the most problems with being physically tired (mean = 75.32 ± 3.90), emotional frustration (mean = 77.31 ± 5.05), and worry (mean standard deviation = 74.23 ± 6.48).

Conclusion

There were demographic differences between neonatal and infantile tracheostomy patients, but they did not affect long‐term outcomes. The presence of a tracheostomy caused a significant impact on a family's quality of life.

Level of Evidence

3. Laryngoscope, 2021

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