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Determinants of successful tracheostomy decannulation in children: a multicentric cohort study

  • C Schweiger (a1) (a2), D Manica (a1), J F Lubianca Neto (a3) (a4), L Sekine (a5), R Krumenauer (a3), J A Caixeta (a6), R Maunsell (a7) and M Gomes Avelino (a6)...

Abstract

Background

Determining prognostic factors for the probability of tracheostomy decannulation is key to an adequate therapeutic plan.

Methods

A retrospective cohort study of 160 paediatric patients undergoing tracheostomy was conducted. Associations between different parameters and eventual tracheostomy decannulation were assessed.

Results

Mean follow-up duration was 27.8 months (interquartile range = 25.5–30.2 months). Median age at tracheostomy was 6.96 months (interquartile range = 3.37–29.42 months), with median tracheostomy maintenance of 14.5 months (interquartile range = 3.7–21.5 months). The overall tracheostomy decannulation rate was 22.5 per cent. Factors associated with a higher probability of tracheostomy decannulation included age at tracheostomy (hazard ratio = 1.11, 95 per cent confidence interval = 1.03–1.18) and post-intubation laryngitis as an indication for tracheostomy (hazard ratio = 2.25, 95 per cent confidence interval = 1.09–4.62). Neurological (hazard ratio = 0.30, 95 per cent confidence interval = 0.12–0.80) and pulmonary (hazard ratio = 0.41, 95 per cent confidence interval = 0.18–0.91) co-morbidities were negatively associated with tracheostomy decannulation. The probability of tracheostomy decannulation decreased significantly with increasing numbers of co-morbidities (p < 0.001).

Conclusion

Age, post-intubation laryngitis, and number and type of co-morbidities influence tracheostomy decannulation rate in the paediatric population.

Copyright

Corresponding author

Author for correspondence: Dr Cláudia Schweiger, Division of Otorhinolaryngology – Head and Neck Surgery, Hospital de Clinicas de Porto Alegre, Ramiro Barcelos, 2350 – Zona 19, Porto Alegre, ZIP code: 90035-003, Brazil E-mail: causch@hotmail.com

Footnotes

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Dr C Schweiger takes responsibility for the integrity of the content of the paper

Footnotes

References

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Keywords

Determinants of successful tracheostomy decannulation in children: a multicentric cohort study

  • C Schweiger (a1) (a2), D Manica (a1), J F Lubianca Neto (a3) (a4), L Sekine (a5), R Krumenauer (a3), J A Caixeta (a6), R Maunsell (a7) and M Gomes Avelino (a6)...

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