Tracheostomy in infants in an Australian Tertiary Children's Hospital: have the indications and outcomes changed?

Objective: To determine if there have been changes over time for indications and outcomes of tracheostomies in infants.

Methods: Retrospective review of infant tracheostomies at a tertiary children's hospital across two time periods (epoch 1: 1997-2008; epoch 2: 2009-2020). Patient demographics, tracheostomy indications, comorbidities, length of stay, complications, decannulation and mortality were examined.

Results: Seventy-two infants had a tracheostomy (40 epoch 1 vs 32 epoch 2). Airway obstruction decreased (80 per cent vs 50 per cent*) and long-term ventilation increased (17.5 per cent vs 40.6 per cent*) as the primary indication. Early complications decreased between the time periods (30 per cent vs 6.3 per cent*). The median hospital length of stay was 97 days (interquartile range 53-205.5), total complication rate was 53 per cent, decannulation rate was 61 per cent and mortality rate was 17 per cent (all non-tracheostomy related) across both time periods. There were no significant changes for these outcomes. *(p< 0.05).

Conclusions: Long-term ventilation has increased and airway obstruction has decreased as the primary indication for infant tracheostomy over time.