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Changes in pediatric tracheostomy 1982-2011: a Canadian tertiary children's hospital review

Lauren N Ogilvie1, Jessica K Kozak1, Simon Chiu1

  • 1Division of Pediatric Otolaryngology, BC Children's Hospital, Division of Otolaryngology, 4480 Oak Street, Vancouver, BC, V6H 3V4.

Journal of Pediatric Surgery
|December 6, 2014
PubMed

Insights

Pediatric tracheostomy trends show fewer infections and more neurological cases over 30 years. While complications rose and decannulation fell, the procedure remains safe and effective for children.

Area of Science:

  • Pediatric Otolaryngology
  • Pediatric Surgery
  • Respiratory Medicine

Background:

  • Pediatric tracheostomy practices have evolved significantly over the last three decades.
  • This study examines trends in pediatric tracheostomy at British Columbia Children's Hospital (BCCH) spanning 30 years.

Purpose of the Study:

  • To analyze changes in the frequency, indications, and outcomes of pediatric tracheostomy.
  • To compare data across three distinct 10-year periods to identify temporal shifts.

Main Methods:

  • Retrospective chart review of 231 pediatric tracheostomy patients from 1982 to 2011.
  • Data collected included demographics, indications, complications, mortality, and decannulation status.
  • Fisher's Exact test was used to analyze changes over time.

Main Results:

  • A total of 251 tracheostomy procedures were reviewed, with a mean age at procedure of 3.74 years.
  • Upper airway obstruction was the most frequent indication (33%).
  • Complication rates were 22%, with a 2.0% tracheostomy-related mortality and a 63% decannulation rate.

Conclusions:

  • Primary indications shifted from infections towards neurological impairments over the study period.
  • Complication rates increased, and the decannulation rate decreased over the 30 years.
  • Pediatric tracheostomy at BCCH is confirmed as a safe and effective intervention.
Abstract

Keywords:
ComplicationsIndicationsPediatricTracheostomy

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