Resen Mette Sørensen, Grønhøj Christian, Hjuler Thomas
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, 2071, Copenhagen University Hospital, Rigshospitalet, 2100, Copenhagen, Denmark.
Eur Arch Otorhinolaryngol. 2018 Mar;275(3):803-808. doi: 10.1007/s00405-018-4872-0. Epub 2018 Jan 22.
Information on the incidence, indications and morbidity of pediatric tracheotomy from a nationwide setting is sparse.
From the nationwide Danish National Patient Registry, we identified all cases: 0-15-year-old children registered with a first-time tracheotomy from 1979 to 2014. We extracted the date of surgery, admission, discharge, age, gender, hospital, department, hospitalization length, hospital contacts, and diagnosis-code related to the surgery. We estimated age-adjusted incidence rates (AAIR) and annual (APC) and average annual percentage change (AAPC) of tracheotomy incidence.
A total of 510 children (328 boys, 63%) underwent tracheotomy. The median age at surgery was 8 years. The AAIR was 1.4/100,000 person-years (range 1.0-1.8) from 1980 to 2014. During 1979-2014, the AAPC decreased - 0.9% (95% confidential interval - 2.4; 0.8, p < 0.3). From 1979 to 2003 the APC decreased - 4.1% (95% CI - 5.4; - 2.8, p < 0.001) and from 2003 to 2014 the APC increased 6.6% (95% CI 2.0; 11.5, p < 0.001). Infants had the highest incidence (4.0/100,000 years) compared with the 12-15-year-olds (AAIR: 0.4/100,000 years). From 1979 to 2014 the most common indication for tracheotomy among children aged 0-2 years was congenital malformations (n = 48, 30%) and among children aged 3-11 and 12-15 years the most common indication was trauma (respectively n = 67, 36% and n = 85, 52%). During 2006-2014 the most common indications for all ages was neurological impairment (n = 25, 21%) and neoplasms (n = 20, 17%).
Pediatric tracheotomy was a rare surgical procedure with decreasing incidence rates from 1980-89 to 1990-99 and increasing incidence rates from 2000-2009 to 2010-2014. Indications and postoperative morbidity have changed adjunct to the treatment of chronic disorders.
关于全国范围内小儿气管切开术的发病率、适应症和发病率的信息很少。
从全国性的丹麦国家患者登记处，我们确定了所有病例：1979年至2014年首次进行气管切开术登记的0至15岁儿童。我们提取了手术日期、入院日期、出院日期、年龄、性别、医院、科室、住院时间、医院接触情况以及与手术相关的诊断代码。我们估计了年龄调整发病率（AAIR）以及气管切开术发病率的年度（APC）和平均年度百分比变化（AAPC）。
共有510名儿童（328名男孩，63%）接受了气管切开术。手术时的中位年龄为8岁。1980年至2014年的AAIR为1.4/100,000人年（范围1.0 - 1.8）。在1979 - 2014年期间，AAPC下降了 - 0.9%（95%置信区间 - 2.4；0.8，p < 0.3）。从1979年到2003年，APC下降了 - 4.1%（95%CI - 5.4； - 2.8，p < 0.001），从2003年到2014年，APC上升了6.6%（95%CI 2.0；11.5，p < 0.001）。婴儿的发病率最高（4.0/100,000年），而12 - 15岁儿童的发病率为（AAIR：0.4/100,000年）。1979年至2014年，0至2岁儿童气管切开术最常见的适应症是先天性畸形（n = 48，30%），3至11岁和12至15岁儿童最常见的适应症是创伤（分别为n = 67，36%和n = 85，52%）。在2006 - 2014年期间，所有年龄段最常见的适应症是神经功能障碍（n = 25，21%）和肿瘤（n = 20，17%）。
小儿气管切开术是一种罕见的外科手术，1980 - 89年至1990 - 99年发病率下降，2000 - 2009年至2010 - 2014年发病率上升。适应症和术后发病率随着慢性疾病治疗的辅助而发生了变化。
