Outcomes of Pediatric Tracheostomy at Sultan Qaboos University Hospital, Oman: A Multidisciplinary Approach

Objectives and rationale Tracheostomy is a surgical procedure associated with a high morbidity rate among neonates and children. Moreover, the decision to perform it is stressful to both parents and physicians, as it is associated with early and late complications and death. However, there are insufficient studies in Oman concerning the outcomes of tracheostomy among children. Therefore, this study aimed to assess the indications, efficacy, outcomes, and complications of tracheostomy performed in children presenting in Sultan Qaboos University Hospital (SQUH), Muscat, Oman, with different indications. Patients and methods A retrospective cohort study was conducted among children (< 14 years old) who had undergone tracheostomy in the department of surgery at SQUH between January 1, 2011, and January 1, 2021. Data were collected from electronic patient records from the hospital information system, and descriptive analysis was used to show the results.  Results A total of 71 children were included in the study. The number of teams involved ranged from two to nine per patient. There were 53 (74.6%) patients who required two to five teams, where 83 (63.8%) complications occurred, while 18 (25.4%) required six to nine teams, where 47 (36.2%) complications developed. The most common early complication was accidental decannulation in 12 (17%) patients, and the most common late complication was colonization by a pathogen occurring in 21 (29.6%) patients. The mortality rate was 26.8% (n=19). The most common cause of death was heart attack/cardiac arrest, where 14 (19.7%) died, followed by 10 (14.1%) deaths due to respiratory failure. The mean duration of hospital stay was 50.18 days (standard deviation (SD) 73.191). Conclusion This study shows a reduction in both early and late complications when more teams are involved in the patient's care. Some of our findings are in line with those mentioned in the literature. This study provided the basis for future retrospective and prospective cohort studies assessing the indications and outcomes of pediatric tracheostomy. We recommend that telemedicine be implemented in the multidisciplinary approach due to its benefits.