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Endotracheal Intubation via Tracheotomy and Subsequent Thoracotomy in Rats for Non-Survival Applications
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Published on: March 15, 2024

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Incidence of Pediatric to Adult Transition Among Tracheotomy Patients

Rebecca Lee1,2, Stephen R Chorney1,2, Yann Fuu Kou1,2

  • 1Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.

The Laryngoscope
|October 8, 2024
PubMed

Insights

Pediatric tracheostomy patients are more likely to transition to adulthood with their breathing tubes if they are older at placement and have severe neurocognitive disabilities. This highlights the need for specialized transition programs for these individuals.

Area of Science:

  • Pediatric Otolaryngology
  • Respiratory Medicine
  • Healthcare Transition

Background:

  • A significant number of children requiring tracheostomy face long-term respiratory support needs.
  • Understanding the trajectory of pediatric tracheostomy patients into adulthood is crucial for effective care planning.

Purpose of the Study:

  • To determine the incidence of pediatric tracheostomy patients who remain tracheostomy-dependent into adulthood.
  • To identify predictors associated with the long-term need for tracheostomy in this population.

Main Methods:

  • Retrospective analysis of 663 pediatric tracheostomy patients from a single tertiary care center (2009-2022).
  • Comparison of demographics, comorbidities, and tracheostomy outcomes (decannulation, mortality, adult status).
  • Logistic regression analysis to identify significant predictors for maintaining tracheostomy into adulthood.

Main Results:

  • 15.5% of pediatric tracheostomy patients (103/663) were projected to reach adulthood by September 2023.
  • Of those reaching adulthood, 25% remained with a tracheostomy, 34% were decannulated, and 24% had died.
  • Predictors for retaining tracheostomy into adulthood included older age at placement (mean 14.3 years), Hispanic ethnicity, not being ventilated at discharge, and severe neurocognitive disabilities.

Conclusions:

  • Older age at tracheostomy placement and severe neurocognitive disabilities are significant predictors for continued tracheostomy use in adulthood.
  • Specialized transition programs are essential to address the unique needs of pediatric tracheostomy patients entering adult care.
Abstract

Keywords:
adult care transitionlong‐term careneurocognitive disabilitiespediatric tracheostomytracheostomy outcomes

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