title: Pediatric tracheotomy in special populations: comparison of operative times and survival.
abstract: We conducted a retrospective study to analyze various aspects of tracheotomy in children with abnormal laryngotracheal anatomy, a congenital cardiac anomaly, both, or neither. Our study population consisted of 53 children who had undergone tracheotomy performed by a single otolaryngologist; 12 patients had abnormal laryngotracheal anatomy and 9 had a cardiac anomaly. Mean operative times were significantly longer in both of these groups than they were in children with normal anatomy (69 vs. 50 min; p < 0.0001) and in children with no cardiac anomaly (65 vs. 53 min; p < 0.05). Post-tracheotomy survival at 1 and 2 years for children with a cardiac anomaly was significantly worse than survival for those without (44 vs. 91%; p < 0.001). Likewise, children who had been intubated for 10 days or more had significantly worse survival than did those who were intubated for less than 10 days (55 vs. 95%; p < 0.001). Finally, we found that the patients with prolonged intubation, respiratory failure, and a cardiac surgical history had higher mortality rates associated with tracheotomy.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Nebraska Medical Center, 981225 Nebraska Medical Center, Omaha, NE 68198, USA.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Craig
authors.forename: Ashley Brooke
authors.initials: AB
authors.lastname: Robey
authors.forename: Debora W
authors.initials: DW
authors.lastname: Goebel
mesh_terms: D000704:Analysis of Variance; D002675:Child, Preschool; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D053208:Kaplan-Meier Estimate; D007830:Larynx / Q000002:abnormalities / Q000033:anatomy & histology / Q000601:surgery*; D008297:Male; D010036:Otolaryngology; D010372:Pediatrics; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013997:Time Factors; D014132:Trachea / Q000002:abnormalities / Q000033:anatomy & histology / Q000601:surgery*; D014140:Tracheotomy; D016896:Treatment Outcome