Tracheostomy in Very Low Birth Weight Infants: A Prospective Multicenter Study.
Black or African American
Chromosome Aberrations
Congenital Abnormalities
/ epidemiology
Ductus Arteriosus, Patent
/ surgery
Female
Hospital Mortality
Humans
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Intracranial Hemorrhages
/ epidemiology
Length of Stay
/ statistics & numerical data
Lung Diseases
/ epidemiology
Male
Prospective Studies
Risk Factors
Sex Factors
Tracheostomy
Journal
Pediatrics
ISSN: 1098-4275
Titre abrégé: Pediatrics
Pays: United States
ID NLM: 0376422
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
accepted:
05
12
2019
pubmed:
27
2
2020
medline:
12
5
2020
entrez:
27
2
2020
Statut:
ppublish
Résumé
In this study, we benchmark outcomes and identify factors associated with tracheostomy placement in infants of very low birth weight (VLBW). Data were prospectively collected on infants of VLBW (401-1500 g or gestational age of 22-29 weeks) born between 2006 and 2016 and admitted to 796 North American centers. Length of stay (LOS), mortality, associated surgical procedures, and comorbidities were assessed, and infants who received tracheostomy were compared with those who did not. Multivariable logistic regressions were performed to identify risk factors for tracheostomy placement and for mortality in those receiving tracheostomy. Of 458 624 infants of VLBW studied, 3442 (0.75%) received tracheostomy. Infants with tracheostomy had a median (interquartile range) LOS of 226 (168-304) days and a mortality rate of 18.8%, compared with 58 (39-86) days and 8.3% for infants without tracheostomy. Independent risk factors associated with tracheostomy placement included male sex, birth weight <1001 g, African American non-Hispanic maternal race, chronic lung disease (CLD), intraventricular hemorrhage, patent ductus arteriosus ligation, and congenital neurologic, cardiac, and chromosomal anomalies. Among infants who received tracheostomy, male sex, birth weight <751 g, CLD, and congenital anomalies were independent predictors of mortality. Infants of VLBW receiving tracheostomy had twice the risk of mortality and nearly 4 times the initial LOS of those without tracheostomy. CLD and congenital anomalies were the strongest predictors of tracheostomy placement and mortality. These benchmark data on tracheostomy in infants of VLBW should guide discussions with patient families and inform future studies and interventions.
Identifiants
pubmed: 32098788
pii: peds.2019-2371
doi: 10.1542/peds.2019-2371
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2020 by the American Academy of Pediatrics.
Déclaration de conflit d'intérêts
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.