Tracheostomy Outcomes in Children With Bronchopulmonary Dysplasia.

Abstract

Objective: To quantify the tracheostomy-related morbidity and mortality, readmissions, and airway interventions in tracheostomy-dependent children with bronchopulmonary dysplasia (BPD).

Study design: Retrospective chart review.

Setting: Tertiary care children's hospital.

Methods: Infants with BPD who received tracheostomy by an otolaryngologist between January 2016 and December 2022 at a single institution were included. Surviving patients were followed to at least 2 years of age. Data were extracted from electronic medical records for patient characteristics, clinical encounters, and surgical visits.

Results: There were 76 patients included in this study. The overall mortality was 30.3% (23/76) with one tracheostomy-related death. Tracheostomy occurred at a median 56 weeks postmenstrual age (PMA). Tracheitis was the most common short- and long-term adverse event (within the first postoperative week, 21%; after postoperative day 7, 81%). Other complications observed include stomal granuloma (77%), airway stenosis (69%), and accidental decannulation (38%). The 30-day and 2-year readmission rates were 32% and 61%, of which 61% and 76% were for tracheostomy-related causes, respectively. The most common reason for readmission over these time periods was tracheitis. Overall decannulation rate for surviving patients was 68%, and decannulation occurred at a median 3.1 years of age. Most surviving patients returned for operative airway intervention (85%); 43% required open airway reconstruction.

Conclusion: Tracheostomy-related morbidity was low in this cohort despite a majority of patients experiencing multiple tracheostomy-related adverse events and readmissions. Patient comorbid conditions, BPD severity, and socioeconomic status were not significantly associated with outcomes. Larger studies are needed to assess the airway interventions and outcomes in this population.