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Author Notes:


KH, MV, KP, and DS contributed to conception and design of the study. MV and CI collected and organized the data. CM performed the statistical analysis and designed the figures. AK wrote the first draft of the manuscript. KH, DS, KP, and CM wrote sections of the manuscript. All authors contributed to manuscript revision, read, and approved the submitted version.

We acknowledge the support of the Children's Healthcare of Atlanta and Emory Department of Pediatrics Biostatistics Core. The study results were presented as a poster at the 2015 Society of Critical Care Medicine Congress.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.



  • tracheostomy
  • pediatric
  • outcome
  • mortality
  • decannulation

Mortality and Outcomes of Pediatric Tracheostomy Dependent Patients


Journal Title:

Frontiers in Pediatrics


Volume 9


Type of Work:

Article | Final Publisher PDF


Objective: To describe clinical factors associated with mortality and causes of death in tracheostomy-dependent (TD) children. Methods: A retrospective study of patients with a new or established tracheostomy requiring hospitalization at a large tertiary children's hospital between 2009 and 2015 was conducted. Patient groups were developed based on indication for tracheostomy: pulmonary, anatomic/airway obstruction, and neurologic causes. The outcome measures were overall mortality rate, mortality risk factors, and causes of death. Results: A total of 187 patients were identified as TD with complete data available for 164 patients. Primary indications for tracheostomy included pulmonary (40%), anatomic/airway obstruction (36%), and neurologic (24%). The median age at tracheostomy and duration of follow up were 6.6 months (IQR 3.5–19.5 months) and 23.8 months (IQR 9.9–46.7 months), respectively. Overall, 45 (27%) patients died during the study period and the median time to death following tracheostomy was 9.8 months (IQR 6.1–29.7 months). Overall survival at 1- and 5-years following tracheostomy was 83% (95% CI: 76–88%) and 68% (95% CI: 57–76%), respectively. There was no significant difference in mortality based on indication for tracheostomy (p = 0.35), however pulmonary indication for tracheostomy was associated with a shorter time to death (HR: 1.9; 95% CI: 1.04–3.4; p = 0.04). Among the co-morbid medical conditions, children with seizure disorder had higher mortality (p = 0.04). Conclusion: In this study, TD children had a high mortality rate with no significant difference in mortality based on indication for tracheostomy. Pulmonary indication for tracheostomy was associated with a shorter time to death and neurologic indication was associated with lower decannulation rates.

Copyright information:

© 2021 Hebbar, Kasi, Vielkind, McCracken, Ivie, Prickett and Simon.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/rdf).
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