title: Risk factors for tracheostomy requirement in extremely low birth weight infants.
abstract: OBJECTIVE
  To identify variables that affect the risk of tracheostomy in a population of extremely low birth weight (ELBW) infants.
  
  
  METHODS
  A retrospective matched case-control study was conducted. ELBW infants with a tracheostomy were compared with controls without tracheostomy. Data collection included demographics, detailed information about each intubation and extubation attempt, the use of steroids and the presence of comorbidities. Statistical analyses include conditional logistic regression and Poisson regression for clustered observations.
  
  
  RESULTS
  Twenty-eight ELBW infants with a tracheostomy were identified. Mean gestational age for both cases and controls was 25 weeks (22-29) and 67.9% were males. Tracheostomy was performed on average on day of life 118 (95%CI: 107-128) and weight at tracheostomy was 2877 g (95%CI: 2657-3098). In the final model, cumulative days with an endotracheal tube (ETT) and total number of intubation episodes were associated with a tracheostomy. For each additional day of intubation, odds of tracheostomy increased by 11% (OR = 1.11, 95%CI: 1.01, 1.23) and with each new intubation episode/failed extubation episode, odds of tracheostomy increased by 150% from the previous episode (OR = 2.5, 95%CI: 1.2, 5.2).
  
  
  CONCLUSIONS
  Greater cumulative exposure to ETT ventilation and number of intubations is associated with having a tracheostomy.
authors.affiliation: a Department of Pediatrics , Yale University School of Medicine , New Haven , CT , USA.
authors.forename: Orly L
authors.initials: OL
authors.lastname: Levit
authors.affiliation: b Yale Center for Analytical Sciences , New Haven , CT , USA.
authors.forename: Veronika
authors.initials: V
authors.lastname: Shabanova
authors.affiliation: a Department of Pediatrics , Yale University School of Medicine , New Haven , CT , USA.
authors.forename: Alia
authors.initials: A
authors.lastname: Bazzy-Asaad
authors.affiliation: a Department of Pediatrics , Yale University School of Medicine , New Haven , CT , USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Bizzarro
authors.affiliation: c Department of Pediatrics , Drexel University College of Medicine , Philadelphia , PA , USA.
authors.forename: Vineet
authors.initials: V
authors.lastname: Bhandari
mesh_terms: D060666:Airway Extubation / Q000009:adverse effects* / Q000706:statistics & numerical data; D016022:Case-Control Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D052577:Infant, Extremely Low Birth Weight; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000706:statistics & numerical data; D008297:Male; D011247:Pregnancy; D012121:Respiration, Artificial / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014139:Tracheostomy / Q000009:adverse effects*
keywords: Bronchopulmonary dysplasia; chronic lung disease; intubation; newborn