Laryngotracheal Reconstruction Outcomes in Children Born Extremely Premature.
extreme prematurity
laryngotracheal reconstruction
prematurity
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
revised:
15
03
2023
received:
20
12
2022
accepted:
05
04
2023
medline:
15
11
2023
pubmed:
26
4
2023
entrez:
26
4
2023
Statut:
ppublish
Résumé
There has been a notable increase in the number of neonates born 28 weeks gestational age or younger in the United States. Many of these patients require tracheostomy early in life and subsequent laryngotracheal reconstruction (LTR). Although extremely premature infants often undergo LTR, there is no known study to date examining their post-surgical outcomes. To compare decannulation rates, time to decannulation and complication rates between LTR patients born extremely premature to those born preterm and term. We identified 179 patients treated at a stand-alone tertiary children's hospital who underwent open airway reconstruction from 2008 to 2021. A Chi Squared test was used to detect differences in categorical clinical data between the groups of patients. A Mann-Whitney test was used to analyze continuous data within these same groups. Time to decannulation analysis was performed using Kaplan Meier analysis and evaluated with log-rank and Cox proportional hazards regression. Children born extremely premature were more likely to incur complications following LTR (OR = 2.363, p = 0.005, CI 1.295-4.247). There was no difference in time to decannulation (p = 0.0543, Log-rank) or rate of decannulation (OR = 0.4985, p = 0.05, CI 0.2511-1.008). Extremely premature infants were more likely to be treated with an anterior and posterior grafts (OR = 2.471, p = 0.004, CI 1.297-4.535) and/or an airway stent (OR = 3.112, p < 0.001, CI 1.539-5.987). Compared with all other patients, extremely premature infants have equivalent decannulation success, but are at an increased risk for complications following LTR. 3 Laryngoscope, 133:3608-3614, 2023.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3608-3614Informations de copyright
© 2023 The American Laryngological, Rhinological and Otological Society, Inc.
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