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

Published online by Cambridge University Press:  08 January 2020

C Schweiger ,
D Manica ,
J F Lubianca Neto ,
L Sekine ,
R Krumenauer ,
J A Caixeta ,
R Maunsell  and
M Gomes Avelino
C Schweiger*
Affiliation:
Division of Otorhinolaryngology – Head and Neck Surgery, Hospital de Clínicas de Porto Alegre, Brazil Programa de Pós-Graduação em Saúde da Criança e do Adolescente (‘PPGSCA’), Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
D Manica
Affiliation:
Division of Otorhinolaryngology – Head and Neck Surgery, Hospital de Clínicas de Porto Alegre, Brazil
J F Lubianca Neto
Affiliation:
Division of Otorhinolaryngology, Hospital da Criança Santo Antônio, Porto Alegre, Brazil Department of Otorhinolaryngology, Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil
L Sekine
Affiliation:
Epidemiologist, Hospital de Clínicas de Porto Alegre, Brazil
R Krumenauer
Affiliation:
Division of Otorhinolaryngology, Hospital da Criança Santo Antônio, Porto Alegre, Brazil
J A Caixeta
Affiliation:
Division of Otorhinolaryngology, Universidade Federal de Goiás, Goiânia, Brazil
R Maunsell
Affiliation:
Division of Otorhinolaryngology, Universidade Estadual de Campinas (‘UNICAMP’), Campinas, Brazil
M Gomes Avelino
Affiliation:
Division of Otorhinolaryngology, Universidade Federal de Goiás, Goiânia, Brazil
*
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
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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.

Keywords

TracheostomyInfantChildProspective StudiesAirway Management

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 1 , January 2020 , pp. 63 - 67
Copyright
Copyright © JLO (1984) Limited, 2020

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Footnotes

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

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