title: Complications in pediatric tracheostomies.
abstract: OBJECTIVE
  To examine complications of pediatric tracheostomy.
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  Chart review of children undergoing tracheotomy or laryngeal diversion between 1990 and 1999.
  
  
  RESULTS
  Charts of 142 children were examined. Average age was 2.64 years (standard deviation [SD], 4.73 y) at surgery. Duration of tracheostomy was 2.08 years (SD, 1.72 y) for those decannulated, 3.12 years (SD, 2.5 y) for those still with a stoma, and length of follow-up for the whole group was 4.14 years (SD, 8.69 y). At last follow-up, 56% had a tracheostomy, 29% had none, and 15% had died; one death was tracheostomy-related. Three percent had intraoperative complications, 11% had complications before the first tracheostomy tube change, and 63% had complications after the first tube change. Thirty-four percent had a trial of decannulation; 85% of these were successful. Fifty-four percent of those decannulated had complications. Number of complications was not related to duration of follow-up. In-hospital mortality was congruent to mortality predicted by PRISM (Pediatric Rate of Mortality) scores.
  
  
  CONCLUSIONS
  Forty-three percent had serious complications involving loss of the tracheostomy airway (tube occlusion or accidental decannulation) or requiring a separate surgical procedure. Deaths directly attributable to tracheostomy complications occurred in 0.7%.
authors.affiliation: Department of Otolaryngology, Children's Hospital of Buffalo, Buffalo, New York, USA. mm.carr@utoronto.ca
authors.forename: M M
authors.initials: MM
authors.lastname: Carr
authors.forename: C P
authors.initials: CP
authors.lastname: Poje
authors.forename: L
authors.initials: L
authors.lastname: Kingston
authors.forename: D
authors.initials: D
authors.lastname: Kielma
authors.forename: C
authors.initials: C
authors.lastname: Heard
mesh_terms: D002675:Child, Preschool; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013997:Time Factors; D014139:Tracheostomy