RT Journal Article
SR Electronic
T1 Tracheostomy in Infants With Congenital Heart Disease: A Nationwide Population-Based Study in Taiwan
JF Respiratory Care
FD American Association for Respiratory Care
SP 958
OP 964
DO 10.4187/respcare.04266
VO 61
IS 7
A1 Lee, Yu-Sheng
A1 Jeng, Mei-Jy
A1 Tsao, Pei-Chen
A1 Soong, Wen-Jue
A1 Chou, Pesus
YR 2016
UL http://rc.rcjournal.com/content/61/7/958.abstract
AB BACKGROUND: This study aimed to use the National Health Insurance Research Database in Taiwan to examine the risk factors for tracheostomy in infants with congenital heart disease (CHD) and to evaluate the associated mortality risk in those who received a tracheostomy.METHODS: The study was conducted between 2000 and 2011 with infants assigned to either a CHD group (34,943 subjects) or an age- and sex-matched control group (136,600 subjects). We then performed descriptive, logistic regression, Kaplan-Meier, and Cox regression analyses for the investigation.RESULTS: Infants with CHD had an increased risk of tracheostomy (adjusted hazard ratio [HR], 6.67, 95% CI 4.40–10.10). Congenital airway anomaly (adjusted odds ratio [OR], 15.25, 95% CI 10.56–22.02), neuromuscular impairment (adjusted OR 6.24, 95% CI 4.35–8.94), and time (0–3 y) after CHD diagnosis (adjusted OR 3.27, 95% CI 2.19–4.89) were most highly correlated with tracheostomy placement. The mortality risk was increased in infants with CHD and a tracheostomy even after adjusting for confounders (adjusted HR 3.88, 95% CI 2.96–5.08). Mortality risk (adjusted HR and 95% CI) increased by 2.06 (1.56–2.71), 7.19 (2.42–21.38), and 14.76 (1.46–149.69) after 0–3, 4–7, and 8–11 y of follow-up, respectively.CONCLUSIONS: Infants with CHD had an increased risk of undergoing tracheostomy. The mortality risk is significantly increased in infants with CHD and tracheostomy, and the risk increases progressively with time. Further studies are warranted to clarify the mechanisms underlying the risks associated with tracheostomy.