{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:17:57Z","timestamp":1791566277855,"version":"4.3.4"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T00:00:00Z","timestamp":1643587200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess trends of clinical practice of tracheostomy and gastrostomy tube (G\u2010tube) placement over a 25\u2010year period and to assess the association of both procedures with outcomes in extremely low birth weight (ELBW) infants (&lt;1000\u2009g).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed and analyzed data obtained from the National Inpatient Sample dataset from 1993 to 2018. ELBW infants who received a tracheostomy and or G\u2010tube\u00a0were included. Regression analysis was performed to assess the association of tracheostomy and\/or G\u2010tube placement with mortality after controlling for confounding variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 620,061 ELBW infants were identified in the weighted sample. Of them, 221,339 were included. G\u2010tube was placed on 4867 (2.2%) infants, tracheostomy was placed on 1788 (0.8%) infants, and both procedures were placed on 1026 (0.46%). Mortality was highest (26.9%) in infants who received tracheostomy only and lowest (5.5%) in those who had G\u2010tube only and (17.8%) in those who had both procedures with adjusted odds ratios of 7.1 (6.3\u20137.9), 0.7 (0.6\u20130.8), and 3.7 (3.1\u20134.4), respectively. The length of stay (LOS) was highest with the combined procedure (219\u2009\u00b1\u2009171), and lowest in the nonintervention group (88\u2009\u00b1\u200957). The trend of G\u2010tube placement has increased over the years (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) but tracheostomy placement has decreased over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Tracheostomy is associated with increased mortality in ELBW infants and increased LOS in survivors whereas the placement of both tracheostomy and G\u2010tube is independently associated with decreased mortality. Prospective studies are needed to assess the relationship between clinical presentation, the timing of the procedure, and outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.25841","type":"journal-article","created":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T06:43:34Z","timestamp":1642747414000},"page":"1022-1030","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Disparities in tracheostomies and gastrostomy tubes in infants at the edge of viability"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2361-983X","authenticated-orcid":false,"given":"Marwa M.","family":"Elgendy","sequence":"first","affiliation":[{"name":"Department of Neonatology, Cleveland Clinic Children's\u00a0Hospital  Cleveland Ohio 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