title: Indications of pediatric tracheostomy over the last 30 years: Has anything changed?
abstract: OBJECTIVE
  Recent reports have shown that the indications for pediatric tracheostomy have evolved over time.
  
  
  OBJECTIVE
  To review the indications for pediatric tracheostomy over the last 30 years.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Tertiary referral children's hospital.
  
  
  METHODS
  Patients who underwent tracheostomy.
  
  
  METHODS
  Surgical tracheostomy placement.
  
  
  METHODS
  Medical records for patients who underwent surgical tracheostomy over the 30-year study period (1984-2014) were reviewed. Patient characteristics including age, gender, birth-weight, gestational age and death were collected and compared with the primary indication for tracheostomy using bivariable analysis.
  
  
  RESULTS
  Five hundred and one patients met inclusion criteria. The most common primary indications for tracheostomy were cardiopulmonary disease (34%) and neurological impairment (32%), followed by airway obstruction (19%), craniofacial (11%), and traumatic injury (4%). Over the last five years (2010-14) cardiopulmonary disease became the most common indication for tracheostomy.
  
  
  CONCLUSIONS
  and
  
  
  CONCLUSIONS
  The indications for pediatric tracheostomy have evolved over the past 30 years. Infectious causes of airway obstruction and tracheostomy have almost disappeared. Tracheostomy is now most commonly performed in very premature patients with cardiopulmonary or neurological impairment who require prolonged ventilator support.
authors.affiliation: Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Ozgul
authors.initials: O
authors.lastname: Gergin
authors.affiliation: Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA.
authors.forename: Eelam A
authors.initials: EA
authors.lastname: Adil
authors.affiliation: Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA; Clinical Research Center, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kawai
authors.affiliation: Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Watters
authors.affiliation: Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Ethan
authors.initials: E
authors.lastname: Moritz
authors.affiliation: Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA. Electronic address: reza.rahbar@childrens.harvard.edu.
authors.forename: Reza
authors.initials: R
authors.lastname: Rahbar
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000628:therapy*; D001724:Birth Weight; D002648:Child; D002675:Child, Preschool; D019465:Craniofacial Abnormalities / Q000628:therapy*; D005260:Female; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000628:therapy*; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008171:Lung Diseases / Q000151:congenital / Q000628:therapy*; D008297:Male; D009422:Nervous System Diseases / Q000628:therapy*; D012121:Respiration, Artificial; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014139:Tracheostomy / Q000639:trends*; D014140:Tracheotomy / Q000639:trends*; D014947:Wounds and Injuries / Q000628:therapy*