Pediatric anesthesia & critical care
Tracheostomy, Feeding-Tube, and In-Hospital Postoperative Mortality in Children: A Retrospective Cohort Study
Authors' conclusion
Patients requiring tracheostomy, feeding tube, or both are generally sicker than patients without these devices. Despite this, having a feeding tube was associated with lower 3-day mortality overall and lower 30-day mortality when the data were stratified by the number of CCCs. Having both devices was associated with lower 3-day mortality in patients presenting for low-risk surgery, and surgery during urgent or emergent hospitalizations.
Study context
- Population
- Children 1 month to 18 years with neuromuscular/neurologic disease having surgery at 44 US children's hospitals, April 2016 to October 2018
- Participants
- 43,193 children · 44 US hospitals
- Exposure
- Tracheostomy, feeding tube, or both vs neither device
- Outcome
- In-hospital postsurgical mortality
- Follow-up
- 3 and 30 days
Methodological detailsmulticentre, Pediatric Health Information System database
- Multicentre
- Pediatric Health Information System database
Main finding
As reported in the abstract
P = 0.003
- Overall unadjusted 3-day mortality, all patients
- 1.3% (549/43,193)
Observational data: associations, not effects.
Further findings
Device use
| Outcome | Neither | Tracheostomy only | Feeding tube only | Both | P value |
|---|---|---|---|---|---|
| 3-day mortality, low-risk surgery (subgroup) · 3 daysBoth vs Neither | 1.9% | — not stated in the abstract | — not stated in the abstract | 0.8% | P = 0.013 |
| 3-day mortality, urgent or emergent hospitalizations (subgroup) · 3 daysBoth vs Neither | 2.9% | — not stated in the abstract | — not stated in the abstract | 1.6% | P = 0.023 |
— not stated in the abstract
30-day in-hospital mortality
- Overall unadjusted 30-day mortality, all patients
- 2.7% (1168/43,193)
- Feeding tube or both devices associated with lower mortality when stratified by number of CCCs
Patient characteristics, either or both devices vs neither
- Less likely to present for high-risk surgeries
- 33% vs 57%
- More likely multiple CCCs, dysphagia, chronic pulmonary disease, cerebral palsy, OSA, malnutrition, and prolonged intensive care unit (ICU) stay within the previous year
Original publication
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