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Risk factor analysis for mortality among infants requiring tracheostomy.

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Infants undergoing tracheostomy have a 14.4% mortality rate within 12 months. Congenital heart disease (CHD) increases mortality risk, while subglottic stenosis (SGS) is associated with better outcomes in these pediatric patients.

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Area of Science:

  • Pediatric Surgery
  • Neonatology
  • Critical Care Medicine

Background:

  • Tracheostomies are increasingly performed in infants with complex conditions like bronchopulmonary dysplasia (BPD) and congenital heart disease (CHD).
  • Characterizing outcomes in this specific infant population is crucial due to evolving indications for tracheostomy.

Purpose of the Study:

  • To assess 12-month mortality rates in infants who underwent tracheostomy.
  • To identify risk factors associated with mortality in this cohort, with a focus on infants with CHD.

Main Methods:

  • A 5-year retrospective chart review of infants ≤12 months at tracheostomy.
  • Evaluation of patient characteristics including age, gestational age, weight, sex, ethnicity, indication, and comorbidities (BPD, CHD, SGS, craniofacial and chromosomal syndromes).

Main Results:

  • Overall 12-month mortality was 14.4% (19/132).
  • Mortality was significantly higher in infants with CHD (35%) and lower in those with SGS (3.7%).
  • No other patient characteristics were linked to mortality differences; a trend towards better outcomes was seen in earlier gestational age births.

Conclusions:

  • Infant tracheostomy mortality is relatively low but significant.
  • CHD is a major risk factor for mortality, whereas SGS is associated with more favorable outcomes.
  • These findings provide essential data on tracheostomy outcomes in infants with complex comorbidities.