{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T06:30:53Z","timestamp":1787207453742,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":230,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Epidemiological data on pediatric tracheostomy are limited, particularly in Asia. We estimated the incidence and evaluated long\u2010term post\u2010tracheostomy outcomes and their predictors using a large Japanese claims database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used the Japanese administrative claims database (JMDC) from 2005 to 2025. All individuals aged &lt;\u200920\u2009years observed during continuous enrollment contributed person\u2010time to the incidence analysis. Individuals who underwent incident tracheostomy constituted the post\u2010tracheostomy cohort. Cumulative incidences of decannulation and death were estimated using competing\u2010risk methods, and predictors of each outcome were evaluated with cause\u2010specific Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 6,046,879 individuals aged &lt;\u200920\u2009years, 1032 underwent incident tracheostomy and constituted the post\u2010tracheostomy cohort (median age, 1.2\u2009years [IQR, 0.4\u201312.6]). The incidence was 4.0 (95% CI, 3.7\u20134.2) per 100,000 person\u2010years; it was highest in infants (&lt;\u20091\u2009year: 42.4) and increased modestly in late adolescence (15\u201319\u2009years: 2.8). The cumulative incidence of decannulation was 22.9% (95% CI, 20.3\u201325.5) at 1\u2009year and 40.6% (95% CI, 37.1\u201344.1) at 5\u2009years; the cumulative incidence of death was 12.9% (95% CI, 10.7\u201315.0) at 1\u2009year and 22.2% (95% CI, 19.4\u201325.1) at 5\u2009years. Older age (6\u201319\u2009years) and trauma were associated with earlier decannulation, whereas malignancy, cardiovascular disease, congenital\/genetic comorbidity, and post\u2013cardiac arrest diagnosis were associated with earlier death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The incidence of pediatric tracheostomy peaked in infancy and increased modestly in late adolescence. During long\u2010term follow\u2010up, substantial proportions of patients experienced decannulation or death, with distinct predictors for each outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70537","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T06:22:22Z","timestamp":1787206942000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence and Long\u2010Term Outcomes of Pediatric Tracheostomy in Japan: A Cohort Study Using a Japanese Claims Database"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8090-5931","authenticated-orcid":false,"given":"Shinya","family":"Miura","sequence":"first","affiliation":[{"name":"Department of Pediatrics St. Marianna University School of Medicine  Kawasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4269-5376","authenticated-orcid":false,"given":"Juma","family":"Obayashi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery St. Marianna University School of Medicine  Kawasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8837-3655","authenticated-orcid":false,"given":"Yusaku","family":"Miyamoto","sequence":"additional","affiliation":[{"name":"Department of Pediatrics St. Marianna University School of Medicine  Kawasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"799","DOI":"10.4187\/respcare.05366","article-title":"Tracheostomy in Infants and Children","volume":"62","author":"Watters K. F.","year":"2017","journal-title":"Respiratory Care"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1002\/lary.29003","article-title":"The Family Impact of Having a Child With a Tracheostomy","volume":"131","author":"Johnson R. F.","year":"2021","journal-title":"Laryngoscope"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1016\/j.jpeds.2018.07.045","article-title":"Caregiver Perceptions About Their Decision to Pursue Tracheostomy for Children With Medical Complexity","volume":"203","author":"Nageswaran S.","year":"2018","journal-title":"Journal of Pediatrics"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1097\/PCC.0000000000002109","article-title":"Parental Conflict, Regret, and Short\u2010Term Impact on Quality of Life in Tracheostomy Decision\u2010Making","volume":"21","author":"October T. W.","year":"2020","journal-title":"Pediatric Critical Care Medicine"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1002\/ppul.23657","article-title":"A Decade of Pediatric Tracheostomies: Indications, Outcomes, and Long\u2010Term Prognosis","volume":"52","author":"McPherson M. L.","year":"2017","journal-title":"Pediatric Pulmonology"},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1038\/s41390-020-01183-x","article-title":"Respiratory, Growth, and Survival Outcomes of Infants With Tracheostomy and Ventilator Dependence","volume":"90","author":"Akangire G.","year":"2021","journal-title":"Pediatric Research"},{"key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"1639","DOI":"10.1002\/ohn.393","article-title":"Long\u2010Term Outcomes of Tracheostomy\u2010Dependent Children","volume":"169","author":"Liu P.","year":"2023","journal-title":"Otolaryngology and Head and Neck Surgery"},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijporl.2021.110989","article-title":"Epidemiology of Pediatric Tracheotomy: A Population\u2010Based Study Using National Health Insurance Research Database in Taiwan","volume":"152","author":"Kang K. 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J.","year":"2018","journal-title":"Pediatric Pulmonology"}],"container-title":["Pediatrics International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.70537","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ped.70537","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.70537","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T06:22:28Z","timestamp":1787206948000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ped.70537"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/ped.70537"],"URL":"https:\/\/doi.org\/10.1111\/ped.70537","archive":["Portico"],"relation":{},"ISSN":["1328-8067","1442-200X"],"issn-type":[{"value":"1328-8067","type":"print"},{"value":"1442-200X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-06-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70537"}}