Tracheostomy trends in preterm infants with bronchopulmonary dysplasia in the United States: 2008-2017.

Journal: Pediatric pulmonology

Volume: 56

Issue: 5

Year of Publication: 2021

Affiliated Institutions:  Department of Pediatrics, University of South Florida, Tampa, Florida, USA. Hart Adventist Hospital, Kumasi, Ghana. Department of Pediatrics and Child Health, Upper West Regional Hospital, Wa, Ghana. Department of Anesthesia, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Department of Pediatrics, BronxCare Health System, Bronx, New York, USA. The Trust Hospital, Accra, Greater Accra Region, Ghana. Department of Pediatrics, Woodhull Medical and Mental Health Center, Brooklyn, New York, USA. Department of Pediatrics, University of Kansas School of Medicine, Wichita, Kansas, USA. Department of Pediatrics, United Hospital Center, Bridgeport, West Virginia, USA. Division of Neonatology, Valley Children's Hospital, Madera, California, USA.

Abstract summary 

To determine the trends in tracheostomy placement and resource use in preterm infants less than or equal to 30 weeks gestational age (GA) with bronchopulmonary dysplasia (BPD) in the United States from 2008 to 2017.This was a retrospective, serial cross-sectional study using data from the NIS. Inclusion criteria were: GA less than or equal to 30 weeks, hospitalization at less than or equal to 28 days of age, assignment of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD9-CM) or ICD10-CM codes for BPD and tracheostomy. Trends in tracheostomy and resource utilization were assessed using Jonckheere-Terpstra test. p-value < .05 was considered significant.Overall, 987 out of 68,953 (1.4%) hospitalizations with BPD had tracheostomy. Characteristics of the study population: 60.8% were male, 68.4% less than or equal to 26 weeks GA, 43.8% White, 60.5% with Medicaid or self-pay, 65.2% in the Midwest and South census regions of the United States, and 45.7% had gastrostomy tube placement. Tracheostomy placement (expressed as per 100,000 live births) decreased from 2.7 in 2008 to 1.9 in 2011. Thereafter, it increased from 1.9 in 2011 to 3.5 in 2017 (p < .001). GA less than or equal to 24 weeks was significantly associated with increased odds of tracheostomy placement. Median length of stay increased significantly from 170 to 231 days while median inflation adjusted hospital cost increased significantly from $323,091 in 2008-2009 to $687,141 between 2008-2009 and 2016-2017.Although tracheostomy placement among preterm hospitalizations with BPD was rare, the frequency of its placement and its associated resource utilization significantly increased during the study period. Future studies should probe the reasons and factors behind these trends.

Authors & Co-authors:  Donda Keyur K Agyemang Christfelly O CO Adjetey Naa A NA Agyekum Afua A Princewill Nimitariye N Ayensu Marian M Bray Leonita L Yagnik Priyank J PJ Bhatt Parth P Dapaah-Siakwan Fredrick F

Study Outcome 

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Citations :  Patel RM. Short- and long-term outcomes for extremely preterm infants. Am J Perinatol. 2016;33(3):318-328.
Authors :  10
Identifiers
Doi : 10.1002/ppul.25273
SSN : 1099-0496
Study Population
Male,Female
Mesh Terms
Bronchopulmonary Dysplasia
Other Terms
gastrostomy tube;national inpatient sample;prematurity;resource utilization;respiratory outcomes
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
United States