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Updated: Jan 19, 2026
Endotracheal Intubation via Tracheotomy and Subsequent Thoracotomy in Rats for Non-Survival Applications
Published on: March 15, 2024
Survival analysis and decannulation outcomes of infants with tracheotomies
Jordan Salley1, Yann-Fuu Kou1, Gopi B Shah1,2
1Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, Texas.
Insights
Pediatric tracheostomy decannulation rates and survival vary by indication. Most patients remained with tracheostomy, with a median decannulation time of 2.5 years and median survival of 6 months.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Pulmonology
- Critical Care Medicine
Background:
- Tracheostomy is a common procedure in pediatric patients, often necessary for airway obstruction or respiratory failure.
- Understanding factors influencing decannulation and survival is crucial for patient management and prognostication.
Purpose of the Study:
- To evaluate differences in time to decannulation and survival rates for pediatric tracheostomy patients.
- To assess the impact of ventilator status at discharge on these outcomes.
Main Methods:
- Retrospective longitudinal cohort study of 305 pediatric tracheostomy patients under age 3.
- Analysis of survival rates using Kaplan-Meier method and time to decannulation using Cox regression.
- Categorization based on mechanical ventilation status and primary reason for tracheostomy.
Main Results:
- 79% of patients were ventilator-dependent at discharge; 15% deceased by study conclusion.
- Patients with ventilator dependence, bronchopulmonary dysplasia, or airway obstruction were more likely to be decannulated.
- Ventilator status at discharge did not impact the probability of death.
Conclusions:
- Time to decannulation and likelihood of decannulation are significantly influenced by the indication for tracheostomy.
- A majority of pediatric tracheostomy patients in this cohort were not decannulated by the study's end.
- Median time to decannulation was 2.5 years, with a median survival time of 6 months.
Objective:
To evaluate for differences in time to decannulation and survival rates for pediatric tracheotomy patients based on ventilator status upon discharge.
Study Design:
Retrospective longitudinal cohort study.
Methods:
A single-institution longitudinal study of pediatric tracheostomy patients was conducted. Patients were categorized based on mechanical ventilation status on discharge and principal reason for tracheostomy. Survival rates were determined using the Kaplan-Meier method. The Wilcoxon's Rank Sum test and Cox regression analysis evaluated differences in survival times and time to decannulation based on primary indication for tracheotomy and ventilation status.
Results:
Chart review identified 305 patients who required a tracheostomy under the age of 3. The median age at the time of tracheotomy was 5.2 months. The indications for tracheotomy in these patients were airway obstruction in 145 (48%), respiratory failure in 214 (70%), and pulmonary toilet in 10 (3.3%). Seventy-nine percent of patients were ventilator dependent at discharge. At the conclusion of the study period, 55% of patients were alive with tracheostomy in place, 30% patients were decannulated, and 15% patients were deceased. Patients with ventilator dependence at initial discharge, bronchopulmonary dysplasia, or airway obstruction were more likely to be decannulated. Hispanic patients were less likely to be decannulated. Patients had an equal probability of death regardless of ventilator status at discharge.
Conclusions:
This study demonstrated that the time to decannulation and likelihood of decannulation varies based on the indication for the tracheostomy. The majority of patients with a tracheostomy were not decannulated at the conclusion of this study. Median time to decannulation was 2.5 years for patients with a median death time of 6 months.
Level Of Evidence:
2b Laryngoscope, 130:2319-2324, 2020.
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