title: Tracheotomy after laryngotracheoplasty: risk factors over 10 years. [Corrected].
abstract: BACKGROUND
  Subglottic stenosis (SGS) is the most common congenital and/or acquired laryngotracheal anomaly requiring tracheotomy in infants. We sought to determine factors associated with a greater likelihood of tracheotomy in symptomatic infants with SGS who underwent laryngotracheoplasty (LTP).
  
  
  METHODS
  Retrospective case series with chart review of patients undergoing single-stage LTP for SGS over a 10-year period (2001-2010) in a tertiary-care pediatric hospital.
  
  
  RESULTS
  Twenty-two children (15 boys, 7 girls), with a mean gestational age of 32.5weeks, underwent LTP with and without interpositional grafting, at a median age of 89days. Ten patients (43%) required postoperative tracheotomy. Of patients weighing <2.5kg, 7 of 8 eventually required tracheotomy, while none weighing >5kg needed tracheotomy (p=0.003). The average length of stay for patients with a tracheotomy was 125days, while those without tracheotomy required only 58days (p=0.011). The grade of SGS (p=0.809), gender (p=0.968), age at surgery (p=0.178), and gestational age (p=0.117) were not significantly associated with the need for tracheotomy. Weight at surgery was significantly correlated with the likelihood of needing tracheotomy (p=0.003).
  
  
  CONCLUSIONS
  Patients who weighed less than 2.5kg at the time of LTP procedures were more likely to require a postoperative tracheotomy. Children who required tracheotomy had longer lengths of hospital stay.
authors.affiliation: Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: maromtal@orange.net.il.
authors.forename: Tal
authors.initials: T
authors.lastname: Marom
authors.affiliation: Christiana Care Health System, Newark, DE, USA; Duquesne University, Pittsburgh, PA, USA.
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Joseph
authors.affiliation: Clinical Otolaryngology, University of Connecticut Health Center, Farmington, CT, USA; Division of Pediatric Otolaryngology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Grindle
authors.affiliation: Division of Pediatric Otolaryngology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA; Departments of Otolaryngology-Head & Neck Surgery and Pediatrics, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Udayan K
authors.initials: UK
authors.lastname: Shah
mesh_terms: D002675:Child, Preschool; D003691:Delaware / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D058753:Laryngoplasty / Q000379:methods*; D007829:Laryngostenosis / Q000151:congenital / Q000601:surgery*; D007830:Larynx / Q000002:abnormalities / Q000601:surgery*; D007902:Length of Stay / Q000639:trends; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014132:Trachea / Q000002:abnormalities / Q000601:surgery*; D014140:Tracheotomy / Q000379:methods*; D016896:Treatment Outcome
keywords: Age; Airway; Graft; Subglottic stenosis; Tracheotomy; Weight