Tracheostomy in infants in an Australian Tertiary Children's Hospital: have the indications and outcomes changed?

OBJECTIVES

To determine if there have been changes over time for indications and outcomes of tracheostomies in infants.

METHODS

Retrospective review of infant tracheostomies at a tertiary children's hospital across two time periods (epoch 1: 1997-2008; epoch 2: 2009-2020). Patient demographics, tracheostomy indications, comorbidities, length of stay, complications, decannulation and mortality were examined.

RESULTS

Seventy-two infants had a tracheostomy (40 epoch 1 32 epoch 2). Airway obstruction decreased (80 per cent 50 per cent*) and long-term ventilation increased (17.5 per cent 40.6 per cent*) as the primary indication. Early complications decreased between the time periods (30 per cent 6.3 per cent*). The median hospital length of stay was 97 days (interquartile range 53-205.5), total complication rate was 53 per cent, decannulation rate was 61 per cent and mortality rate was 17 per cent (all non-tracheostomy related) across both time periods. There were no significant changes for these outcomes. *(p< 0.05).

CONCLUSION

Long-term ventilation has increased and airway obstruction has decreased as the primary indication for infant tracheostomy over time.