Tracheotomy after laryngotracheoplasty: risk factors over 10 years. [Corrected]

Subglottic stenosis (SGS) is the most common congenital and/or acquired laryngotracheal anomaly requiring tracheotomy in infants. We sought to determine factors associated with a greater likelihood of tracheotomy in symptomatic infants with SGS who underwent laryngotracheoplasty (LTP). Retrospective...

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Bibliographic Details
Published in:Journal of pediatric surgery 2014-08, Vol.49 (8), p.1206-1209
Main Authors: Marom, Tal, Joseph, Rachel A, Grindle, Christopher R, Shah, Udayan K
Format: Article
Language:English
Subjects:
Child, Preschool
Delaware - epidemiology
Female
Follow-Up Studies
Forecasting
Gestational Age
Humans
Incidence
Infant
Infant, Newborn
Laryngoplasty - methods
Laryngostenosis - congenital
Laryngostenosis - surgery
Larynx - abnormalities
Larynx - surgery
Length of Stay - trends
Male
Postoperative Complications - epidemiology
Retrospective Studies
Risk Assessment
Risk Factors
Trachea - abnormalities
Trachea - surgery
Tracheotomy - methods
Treatment Outcome
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Summary:Subglottic stenosis (SGS) is the most common congenital and/or acquired laryngotracheal anomaly requiring tracheotomy in infants. We sought to determine factors associated with a greater likelihood of tracheotomy in symptomatic infants with SGS who underwent laryngotracheoplasty (LTP). Retrospective case series with chart review of patients undergoing single-stage LTP for SGS over a 10-year period (2001-2010) in a tertiary-care pediatric hospital. Twenty-two children (15 boys, 7 girls), with a mean gestational age of 32.5weeks, underwent LTP with and without interpositional grafting, at a median age of 89days. Ten patients (43%) required postoperative tracheotomy. Of patients weighing 5kg needed tracheotomy (p=0.003). The average length of stay for patients with a tracheotomy was 125days, while those without tracheotomy required only 58days (p=0.011). The grade of SGS (p=0.809), gender (p=0.968), age at surgery (p=0.178), and gestational age (p=0.117) were not significantly associated with the need for tracheotomy. Weight at surgery was significantly correlated with the likelihood of needing tracheotomy (p=0.003). Patients who weighed less than 2.5kg at the time of LTP procedures were more likely to require a postoperative tracheotomy. Children who required tracheotomy had longer lengths of hospital stay.
ISSN:1531-5037
DOI:10.1016/j.jpedsurg.2013.11.065