Medical and social factors as predictors of outcome in infant tracheostomy

Abstract

SummaryWe examined the relative impact of infant tracheostomy in comparison to. associated medical and social factors, on developmental outcome as part of a cross-sectional follow-up of 32 children. These children had no mental retardation, physical handicap, or severe neurological problems, but had a history of long-term tracheostomy in infancy, ranging from 3 to 146 months duration.Medical factors evaluated included prematurity, neurological status, severity of illness, and number of weeks hospitalized. Social factors included parental education and occupation. Outcome measures included IQ, language quotient, growth parameters, and behavioral competence. Correlation analyses, stepwise multiple regression analyses, and t-tests were used.Early medical illnesses were significant predictors of cognitive, language, and growth outcome. Severity of medical complications at birth and the presence of any neurological problem predicted 49% of the variance in IQ at follow-up. Social class was the only variable to predict behavioral outcome, accounting for 28% of the variance. For children without confounding medical conditions, tracheostomy had a negative impact on overall language and auditory comprehension. Once children with confounding medical risk factors were removed from the sample, children with history of infant tracheostomy exhibited significantly lower overall mean lanugage scores (106 versus 120), and lower mean language comprehension scores (104 versus 119) than a matched comparison group.

Tracheostomy speaking valves for children: tolerance and clinical benefits

“…For the older child who has undergone tracheostomy placement, there is often a loss of the ability to communicate verbally. Previous studies have shown that tracheostomy placement negatively affects the development of expressive language skills in children, including phonation, vocal quality and articulation [3][4][5][6][7][8].…”

Critical Illness and Amputation in Meningococcal Septicemia: Is Life Worth Saving?

“…The lack of a simple relationship between functional or patient-centered outcomes and disease severity has been observed for many other conditions. [9][10][11][12] The only participant in our series with poor outcomes in physical and psychological evaluations, despite less-severe amputation, also had brain involvement. This might be an important association, because cognitive skills may have an important protective or compensatory function.…”

Custom-made intraoral mandibular distraction as treatment for neonatal airway obstruction

“…Besides the morbidity and mortality of tracheotomy, patients with history of tracheotomy in infancy are associated with lower overall language and auditory comprehension, speech developing problems and moderate to severe mental and physical impairments 25,26 . Caretakers of tracheotomized patients often score low on all aspects of quality of life including sleep, relationships, social life and ability to work 13 .…”