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. 2023 Mar;49(2):408-414.
doi: 10.1016/j.burns.2022.04.015. Epub 2022 Apr 22.

Retrospective outcomes analysis of tracheostomy in a paediatric burn population

Nicholas J Iglesias  1 , Anesh Prasai  2 , George Golovko  3 , Deepak K Ozhathil  4 , Steven E Wolf  5
Affiliations

Retrospective outcomes analysis of tracheostomy in a paediatric burn population

Nicholas J Iglesias et al. Burns. 2023 Mar.

Abstract

Introduction: Previous analyses of tracheostomy in paediatric burns was hindered by a lack of multi-institution or nationwide analysis. This study aims to explore the effects of tracheostomy in paediatric burn patients in such an analysis. De-identified data was obtained from the TriNetX Research Network database.

Methods: Two cohorts were identified using ICD and CPT codes: paediatric burn patients with tracheostomy (cohort 1) and paediatric burn patients without tracheostomy (cohort 2). Cohorts were matched according to age at diagnosis and pulmonary condition, specifically influenza and pneumonia, respiratory failure, acute upper respiratory infection, and pulmonary collapse. Cohorts were also matched for age at burn diagnosis and surface area burned. Several parameters including infection following a procedure, sepsis, volume depletion, respiratory disorders, laryngeal disorders, pneumonia, and other metrics were also compared.

Results: A total of 152 patients were matched according to age and pulmonary condition. Cohort 1 and cohort 2 had a mean age of 4.45 ± 4.06 and 4.39 ± 3.99 years, respectively. Matched patients with tracheostomy had a higher risk for pneumonia, respiratory failure, other respiratory disorders, diseases of the vocal cord and larynx, sepsis, volume depletion, pulmonary edema, and respiratory arrest. The risk ratios for these outcomes were 2.96, 3.5, 3.13, 3.9, 2.5, 2.5, 3.3, and not applicable. Analysis of longitudinal outcomes of paediatric burn patients with tracheostomy vs. those without demonstrated the tracheostomy cohort suffered much worse morbidity and experienced higher health burden across several metrics.

Conclusion: The potential benefits of tracheostomy in paediatric burn patients should be weighed against these outcomes.

Keywords: Airway; Burn; Outcomes; Paediatrics; Ventilation.

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Conflict of interest statement

Declaration of Interest Authors declare no conflicts of interest other than SEW is the Editor of this journal.

Figures

Fig. 1 –
Fig. 1 –
(A) Flow diagram of the outcomes analyzed in paediatric burn patients with and without tracheostomy when matching for age and pulmonary condition. (B) Flow diagram of the outcomes analyzed in paediatric burn patients with and without tracheostomy when matching for age and TBSA.
Fig. 2 –
Fig. 2 –
% TBSA in paediatric burn patients with and without tracheostomy when matching for age/pulmonary condition (cohorts 1a and 2a) and age/TBSA (cohorts 1b and 2b).
See this image and copyright information in PMC

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