title: Changes in pediatric tracheostomy 1982-2011: a Canadian tertiary children's hospital review.
abstract: BACKGROUND
  Pediatric tracheostomy has undergone notable changes in frequency and indication over the past 30 years. This study investigates pediatric tracheostomy at British Columbia Children's Hospital (BCCH) over a 30-year period.
  
  
  METHODS
  A retrospective chart review of tracheostomy cases at BCCH from 1982 to 2011 was conducted. Charts were reviewed for demographics, date of tracheostomy, indication, complications, mortality and date of decannulation. Data from three 10-year time periods were compared using Fisher's Exact test to examine changes over time.
  
  
  RESULTS
  251 procedures (154 males) performed on 231 patients were reviewed. Mean age at tracheostomy was 3.74 years with 48% of procedures undertaken before the age of one year. Frequency of procedure by year has generally declined into the early 2000's. Upper airway obstruction was the most common indication accounting for 33% of procedures. The rate of complication across the entire cohort was 22% with 63% of patients being decannulated. Tracheostomy related mortality occurred in 2.0% of cases reviewed.
  
  
  CONCLUSIONS
  Changes occurred in primary indications with infections indicating less procedures and neurological impairments indicating more procedures over time. Complications increased and the decannulation rate decreased over this 30-year review. Pediatric tracheostomy is considered a safe and effective procedure at BCCH.
authors.affiliation: Division of Pediatric Otolaryngology, BC Children's Hospital, Division of Otolaryngology, 4480 Oak Street, Vancouver, BC, V6H 3V4.
authors.forename: Lauren N
authors.initials: LN
authors.lastname: Ogilvie
authors.affiliation: Division of Pediatric Otolaryngology, BC Children's Hospital, Division of Otolaryngology, 4480 Oak Street, Vancouver, BC, V6H 3V4.
authors.forename: Jessica K
authors.initials: JK
authors.lastname: Kozak
authors.affiliation: Division of Pediatric Otolaryngology, BC Children's Hospital, Division of Otolaryngology, 4480 Oak Street, Vancouver, BC, V6H 3V4.
authors.forename: Simon
authors.initials: S
authors.lastname: Chiu
authors.affiliation: Home Tracheostomy Care and Home Ventilation Program, BC Children's Hospital, 4480 Oak Street, Vancouver, BC, V6H 3V4.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Adderley
authors.affiliation: Division of Pediatric Otolaryngology, BC Children's Hospital, Division of Otolaryngology, 4480 Oak Street, Vancouver, BC, V6H 3V4. Electronic address: fkozak@cw.bc.ca.
authors.forename: Frederick K
authors.initials: FK
authors.lastname: Kozak
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000601:surgery; D001955:British Columbia; D002648:Child; D002675:Child, Preschool; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D010808:Physical Examination; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014139:Tracheostomy / Q000009:adverse effects / Q000379:methods / Q000639:trends
keywords: Complications; Indications; Pediatric; Tracheostomy