Tracheostomy After Operations for Congenital Heart Disease: An Analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database

Christopher W. Mastropietro, Brian D. Benneyworth, Mark Turrentine, Amelia S. Wallace, Christoph P. Hornik, Jeffery P. Jacobs, Marshall L. Jacobs

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Information concerning tracheostomy after operations for congenital heart disease has come primarily from single-center reports. We aimed to describe the epidemiology and outcomes associated with postoperative tracheostomy in a multi-institutional registry. Methods: The Society of Thoracic Surgeons Congenital Heart Database (2000 to 2014) was queried for all index operations with the adverse event "postoperative tracheostomy" or "respiratory failure, requiring tracheostomy." Patients with preoperative tracheostomy or weighing less than 2.5 kg undergoing isolated closure of patent ductus arteriosus were excluded. Trends in tracheostomy incidence over time from January 2000 to June 2014 were analyzed with a Cochran-Armitage test. The patient characteristics associated with operative mortality were analyzed for January 2010 to June 2014, including deaths occurring up to 6 months after transfer of patients to long-term care facilities. Results: From 2000 to 2014, the incidence of tracheostomy after operations for congenital heart disease increased from 0.11% in 2000 to a high of 0.76% in 2012 (p <0.0001). From 2010 to 2014, 648 patients underwent tracheostomy. The median age at operation was 2.5 months (25th, 75th percentile: 0.4, 7). Prematurity (n = 165, 26%), genetic abnormalities (n = 298, 46%), and preoperative mechanical ventilation (n = 275, 43%) were common. Postoperative adverse events were also common, including cardiac arrest (n = 131, 20%), extracorporeal support (n = 87, 13%), phrenic or laryngeal nerve injury (n = 114, 18%), and neurologic deficit (n = 51, 8%). The operative mortality was 25% (n = 153). Conclusions: Tracheostomy as an adverse event of operations for congenital heart disease remains rare but has been increasingly used over the past 15 years. This trend and the considerable mortality risk among patients requiring postoperative tracheostomy support the need for further research in this complex population.

Original languageEnglish (US)
JournalAnnals of Thoracic Surgery
DOIs
StateAccepted/In press - 2016

Fingerprint

Tracheostomy
Thoracic Surgery
Heart Diseases
Databases
Mortality
Laryngeal Nerve Injuries
Patient Transfer
Phrenic Nerve
Patent Ductus Arteriosus
Incidence
Long-Term Care
Neurologic Manifestations
Heart Arrest
Artificial Respiration
Respiratory Insufficiency
Registries
Epidemiology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Tracheostomy After Operations for Congenital Heart Disease : An Analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database. / Mastropietro, Christopher W.; Benneyworth, Brian D.; Turrentine, Mark; Wallace, Amelia S.; Hornik, Christoph P.; Jacobs, Jeffery P.; Jacobs, Marshall L.

In: Annals of Thoracic Surgery, 2016.

Research output: Contribution to journalArticle

Mastropietro, Christopher W. ; Benneyworth, Brian D. ; Turrentine, Mark ; Wallace, Amelia S. ; Hornik, Christoph P. ; Jacobs, Jeffery P. ; Jacobs, Marshall L. / Tracheostomy After Operations for Congenital Heart Disease : An Analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database. In: Annals of Thoracic Surgery. 2016.
@article{3cc6a7c1765148ae84c257e696ee2e0c,
title = "Tracheostomy After Operations for Congenital Heart Disease: An Analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database",
abstract = "Background: Information concerning tracheostomy after operations for congenital heart disease has come primarily from single-center reports. We aimed to describe the epidemiology and outcomes associated with postoperative tracheostomy in a multi-institutional registry. Methods: The Society of Thoracic Surgeons Congenital Heart Database (2000 to 2014) was queried for all index operations with the adverse event {"}postoperative tracheostomy{"} or {"}respiratory failure, requiring tracheostomy.{"} Patients with preoperative tracheostomy or weighing less than 2.5 kg undergoing isolated closure of patent ductus arteriosus were excluded. Trends in tracheostomy incidence over time from January 2000 to June 2014 were analyzed with a Cochran-Armitage test. The patient characteristics associated with operative mortality were analyzed for January 2010 to June 2014, including deaths occurring up to 6 months after transfer of patients to long-term care facilities. Results: From 2000 to 2014, the incidence of tracheostomy after operations for congenital heart disease increased from 0.11{\%} in 2000 to a high of 0.76{\%} in 2012 (p <0.0001). From 2010 to 2014, 648 patients underwent tracheostomy. The median age at operation was 2.5 months (25th, 75th percentile: 0.4, 7). Prematurity (n = 165, 26{\%}), genetic abnormalities (n = 298, 46{\%}), and preoperative mechanical ventilation (n = 275, 43{\%}) were common. Postoperative adverse events were also common, including cardiac arrest (n = 131, 20{\%}), extracorporeal support (n = 87, 13{\%}), phrenic or laryngeal nerve injury (n = 114, 18{\%}), and neurologic deficit (n = 51, 8{\%}). The operative mortality was 25{\%} (n = 153). Conclusions: Tracheostomy as an adverse event of operations for congenital heart disease remains rare but has been increasingly used over the past 15 years. This trend and the considerable mortality risk among patients requiring postoperative tracheostomy support the need for further research in this complex population.",
author = "Mastropietro, {Christopher W.} and Benneyworth, {Brian D.} and Mark Turrentine and Wallace, {Amelia S.} and Hornik, {Christoph P.} and Jacobs, {Jeffery P.} and Jacobs, {Marshall L.}",
year = "2016",
doi = "10.1016/j.athoracsur.2016.01.046",
language = "English (US)",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",

}

TY - JOUR

T1 - Tracheostomy After Operations for Congenital Heart Disease

T2 - An Analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database

AU - Mastropietro, Christopher W.

AU - Benneyworth, Brian D.

AU - Turrentine, Mark

AU - Wallace, Amelia S.

AU - Hornik, Christoph P.

AU - Jacobs, Jeffery P.

AU - Jacobs, Marshall L.

PY - 2016

Y1 - 2016

N2 - Background: Information concerning tracheostomy after operations for congenital heart disease has come primarily from single-center reports. We aimed to describe the epidemiology and outcomes associated with postoperative tracheostomy in a multi-institutional registry. Methods: The Society of Thoracic Surgeons Congenital Heart Database (2000 to 2014) was queried for all index operations with the adverse event "postoperative tracheostomy" or "respiratory failure, requiring tracheostomy." Patients with preoperative tracheostomy or weighing less than 2.5 kg undergoing isolated closure of patent ductus arteriosus were excluded. Trends in tracheostomy incidence over time from January 2000 to June 2014 were analyzed with a Cochran-Armitage test. The patient characteristics associated with operative mortality were analyzed for January 2010 to June 2014, including deaths occurring up to 6 months after transfer of patients to long-term care facilities. Results: From 2000 to 2014, the incidence of tracheostomy after operations for congenital heart disease increased from 0.11% in 2000 to a high of 0.76% in 2012 (p <0.0001). From 2010 to 2014, 648 patients underwent tracheostomy. The median age at operation was 2.5 months (25th, 75th percentile: 0.4, 7). Prematurity (n = 165, 26%), genetic abnormalities (n = 298, 46%), and preoperative mechanical ventilation (n = 275, 43%) were common. Postoperative adverse events were also common, including cardiac arrest (n = 131, 20%), extracorporeal support (n = 87, 13%), phrenic or laryngeal nerve injury (n = 114, 18%), and neurologic deficit (n = 51, 8%). The operative mortality was 25% (n = 153). Conclusions: Tracheostomy as an adverse event of operations for congenital heart disease remains rare but has been increasingly used over the past 15 years. This trend and the considerable mortality risk among patients requiring postoperative tracheostomy support the need for further research in this complex population.

AB - Background: Information concerning tracheostomy after operations for congenital heart disease has come primarily from single-center reports. We aimed to describe the epidemiology and outcomes associated with postoperative tracheostomy in a multi-institutional registry. Methods: The Society of Thoracic Surgeons Congenital Heart Database (2000 to 2014) was queried for all index operations with the adverse event "postoperative tracheostomy" or "respiratory failure, requiring tracheostomy." Patients with preoperative tracheostomy or weighing less than 2.5 kg undergoing isolated closure of patent ductus arteriosus were excluded. Trends in tracheostomy incidence over time from January 2000 to June 2014 were analyzed with a Cochran-Armitage test. The patient characteristics associated with operative mortality were analyzed for January 2010 to June 2014, including deaths occurring up to 6 months after transfer of patients to long-term care facilities. Results: From 2000 to 2014, the incidence of tracheostomy after operations for congenital heart disease increased from 0.11% in 2000 to a high of 0.76% in 2012 (p <0.0001). From 2010 to 2014, 648 patients underwent tracheostomy. The median age at operation was 2.5 months (25th, 75th percentile: 0.4, 7). Prematurity (n = 165, 26%), genetic abnormalities (n = 298, 46%), and preoperative mechanical ventilation (n = 275, 43%) were common. Postoperative adverse events were also common, including cardiac arrest (n = 131, 20%), extracorporeal support (n = 87, 13%), phrenic or laryngeal nerve injury (n = 114, 18%), and neurologic deficit (n = 51, 8%). The operative mortality was 25% (n = 153). Conclusions: Tracheostomy as an adverse event of operations for congenital heart disease remains rare but has been increasingly used over the past 15 years. This trend and the considerable mortality risk among patients requiring postoperative tracheostomy support the need for further research in this complex population.

UR - http://www.scopus.com/inward/record.url?scp=84964330165&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84964330165&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2016.01.046

DO - 10.1016/j.athoracsur.2016.01.046

M3 - Article

C2 - 27083243

AN - SCOPUS:84964330165

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

ER -