title: The decline of tracheotomy among otolaryngologists: a 14-year review.
abstract: OBJECTIVE
  To determine the trend of number of tracheotomies performed by otolaryngologists.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Tertiary referral center in central Pennsylvania.
  
  
  METHODS
  All patients undergoing tracheotomy between 2000 and 2013.
  
  
  METHODS
  Data were gathered from billing records and operative reports to determine the service performing the tracheotomy. In addition, the surgical technique and indication for surgery were recorded. Negative binomial regressions were conducted to examine the number of tracheotomies performed by each specialty as a function of year.
  
  
  RESULTS
  In 2000, 44% of tracheotomies were being performed by the otolaryngology service, compared with only 25% in 2013. This is a decline of 22% over time. Since 2000, general surgery steadily increased the number of tracheotomies performed in comparison to the steady decrease performed by otolaryngology. Since 2008, general surgeons have significantly increased the number of percutaneous tracheotomies they perform (76% per year). Over the same period, the number of tracheotomies performed by the cardiothoracic surgery service has steadily increased by 26% per year. Most of the tracheotomies performed by cardiothoracic surgery are percutaneous tracheotomies.
  
  
  CONCLUSIONS
  This study illustrates that otolaryngologists at our institution are performing fewer tracheotomies over time. If this trend continues, the experience of our trainees may become diluted through reduction in surgical volume. While multi-institutional studies are warranted, this review provides a summary of data collected at a tertiary care institution, which may reflect national trends.
authors.affiliation: Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA.
authors.forename: Hetal H
authors.initials: HH
authors.lastname: Patel
authors.affiliation: Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA.
authors.forename: Aldis
authors.initials: A
authors.lastname: Siltumens
authors.affiliation: Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA.
authors.forename: Leah
authors.initials: L
authors.lastname: Bess
authors.affiliation: Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA.
authors.forename: Fabian
authors.initials: F
authors.lastname: Camacho
authors.affiliation: Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA dgoldenberg@hmc.psu.edu.
authors.forename: David
authors.initials: D
authors.lastname: Goldenberg
mesh_terms: D003657:Decision Making; D005544:Forecasting; D006801:Humans; D010036:Otolaryngology; D010414:Pennsylvania; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D014140:Tracheotomy / Q000706:statistics & numerical data*
keywords: otolaryngology; percutaneous; tracheotomy; training