(779) Long-Term Mortality and Associated Demographic Factors of Children With Tracheostomies

Introduction: With an increase in the availability of life-saving therapies, the number of tracheostomies in children has increased. Previous studies have described clinical outcomes related to hospitalizations during which tracheostomies are placed, but due to difficulty tracking children across hospital systems over time, few studies have examined long-term clinical outcomes of children with tracheostomy. We sought to describe the demographics and long term mortality of children with tracheostomy.

Methods: We conducted a single center retrospective study of children admitted to Hadassah University Medical Center (Jerusalem, Israel) who underwent tracheostomy placement. Demographics, clinical and procedural codes were collected from the medical record and linked to mortality data from the national Ministry of Health. A multivariate logistic regression model was constructed to determine the association between demographic variables and overall mortality.

Results: Six hundred sixty-eight children underwent tracheostomy placement from 2000-2022. The median (IQR) number of tracheostomies placed each year was 27 (24-33). Sixty-two percent of the patients were male with a median (IQR) age of 30 (8-120) months. Fifty percent of the children were Jewish and forty-four percent were Muslim. Thirteen percent of children had traumatic injuries, 8% had a cardiac arrest and 4% were premature infants ( < 33 weeks gestation). The overall mortality was 31% (95% CI 28-35%). After adjusting for age, gender, and year of tracheostomy placement, Jewish children were more likely to subsequently die as compared to Muslim children, OR 1.632, 95% CI 1.152-2.312, p=0.006.

Conclusions: The overall mortality for children with tracheostomies is high. Differences in mortality were observed based on the religious affiliation of the families. Further studies should explore the medical, cultural, and socioeconomic differences that may account for these observations.