Pediatric Tracheostomy at a Tertiary Healthcare Institution: A Retrospective Study Focused on Outcomes
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ORIGINAL ARTICLE
Pediatric Tracheostomy at a Tertiary Healthcare Institution: A Retrospective Study Focused on Outcomes Ahmet Yukkaldıran1
•
Ahmet Doblan2
Received: 15 June 2020 / Accepted: 24 August 2020 Ó Association of Otolaryngologists of India 2020
Abstract The aim of this study was to retrospectively evaluate all pediatric tracheotomies that had been performed at Sanliurfa Training and Research Hospital From September 2016 to July 2019. A retrospective study was performed on pediatric patients who had undergone tracheostomy during the three-year study period. Patient data were reviewed for the following variables: age, gender, age at the time of tracheostomy, primary indication for tracheostomy, length of stay in intensive care unit before and after tracheostomy, complications, mortality and cause of death. The primary indication for tracheostomy was categorized into 4 separate groups: congenital disease, traumatic injury, prolonged intubation and other causes. The study group consisted of 138 children. Seventy-one (51.4%) of the children were male, 67 (48.6%) were female and the mean age of tracheostomy was 13.30 (0.03–192.27) months, and 44.2% were younger than 1 year when tracheotomy was performed. The median age at the time of tracheostomy was highest in children who underwent tracheostomy for traumatic injury. The indication for tracheostomy was prolonged intubation in 73.2% of the children. Complications were observed in 13 (9%) children; bleeding (69.2%) was the most common. Complications were most frequent in children who underwent tracheostomy for prolonged intubation. The overall mortality ratewas 30.4% with cardiac arrest being the most common cause. At our center, the most common indication & Ahmet Yukkaldıran [email protected] 1
Department of Otorhinolaryngology, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
2
¨ Mehmet Akif ˙Inan Department of Otorhinolaryngology, SBU Training and Research Hospital, Sanliurfa, Turkey
for tracheostomy in children was long-term intubation, possibly due to our center being a tertiary healthcare institute. Bleeding was the most common complication, while cardiac arrest was the most common cause of death. Keywords Tracheostomy Prolonged intubation Airway obstruction Pediatric intensive care
Introduction In recent years, the indications and complications of tracheostomy and the epidemiological profile of recipients have evolved [1]. The best examples of these changes may be the increased rate of vaccination for croup, diphtheria and epiglottitis, as well as the ever-decreasing rate of patients undergoing tracheostomy for these reasons [2]. Other obstructive indications include craniofacial malformations, subglottic stenosis, tracheomalacia, and tumors that block the airway. In the past, the most common indication for tracheostomy was airway obstruction [2, 3]. In addition to the need for endotracheal intubation due to pulmonary or cardiac malformations, chronic pulmonary insufficiency, neurological disorders and cervical trauma, the d
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