title: Trends in the use of tracheotomy in the pediatric patient: the Iowa experience.
abstract: BACKGROUND
  The role of tracheotomy in airway management in children has been widely discussed. Improved medical care and technology have resulted in improved survival rates, and increased survival rates have been associated with changes in the indications for and the use of tracheotomy. The purpose of this review was to evaluate trends in the use of tracheotomy over a 15-year period.
  
  
  METHODS
  We reviewed the medical charts of patients who underwent tracheotomy from 1975 to 1989 and analyzed them over three 5-year time intervals: Block 1, 1975-79; Block 2, 1980-84; and Block 3, 1985-89.
  
  
  RESULTS
  In the defined age group, 305 patients underwent tracheotomy during the study period. Records from 281 patients were analyzed; the remaining charts either were unavailable for review or did not contain adequate documentation of the tracheotomy. We observed an increase in the number of tracheotomies over time, especially in the younger population. Across blocks, median age decreased, duration of tracheotomy increased, and indications for tracheotomy changed.
  
  
  CONCLUSIONS
  Mean age, duration of tracheotomy, and indications for tracheotomy changed over the 15-year period. Additionally, these parameters were strongly related.
authors.affiliation: University of Iowa, Department of Speech Pathology and Audiology, Iowa City, Iowa, USA.
authors.forename: P M
authors.initials: PM
authors.lastname: Palmer
authors.forename: J M
authors.initials: JM
authors.lastname: Dutton
authors.forename: T M
authors.initials: TM
authors.lastname: McCulloch
authors.forename: R J
authors.initials: RJ
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000402:Airway Obstruction / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007484:Iowa; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D017678:Sex Distribution; D015996:Survival Rate; D014140:Tracheotomy / Q000706:statistics & numerical data* / Q000639:trends