Incidence and Long-Term Outcomes of Pediatric Tracheostomy in Japan: A Cohort Study Using a Japanese Claims Database.

Authors

Shinya Miura, Juma Obayashi, Yusaku Miyamoto

Published in

Pediatrics international : official journal of the Japan Pediatric Society. Volume 68. Issue 1. Pages e70537.

Abstract

Epidemiological data on pediatric tracheostomy are limited, particularly in Asia. We estimated the incidence and evaluated long-term post-tracheostomy outcomes and their predictors using a large Japanese claims database.
We used the Japanese administrative claims database (JMDC) from 2005 to 2025. All individuals aged < 20 years observed during continuous enrollment contributed person-time to the incidence analysis. Individuals who underwent incident tracheostomy constituted the post-tracheostomy cohort. Cumulative incidences of decannulation and death were estimated using competing-risk methods, and predictors of each outcome were evaluated with cause-specific Cox proportional hazards models.
Among 6,046,879 individuals aged < 20 years, 1032 underwent incident tracheostomy and constituted the post-tracheostomy cohort (median age, 1.2 years [IQR, 0.4-12.6]). The incidence was 4.0 (95% CI, 3.7-4.2) per 100,000 person-years; it was highest in infants (< 1 year: 42.4) and increased modestly in late adolescence (15-19 years: 2.8). The cumulative incidence of decannulation was 22.9% (95% CI, 20.3-25.5) at 1 year and 40.6% (95% CI, 37.1-44.1) at 5 years; the cumulative incidence of death was 12.9% (95% CI, 10.7-15.0) at 1 year and 22.2% (95% CI, 19.4-25.1) at 5 years. Older age (6-19 years) and trauma were associated with earlier decannulation, whereas malignancy, cardiovascular disease, congenital/genetic comorbidity, and post-cardiac arrest diagnosis were associated with earlier death.
The incidence of pediatric tracheostomy peaked in infancy and increased modestly in late adolescence. During long-term follow-up, substantial proportions of patients experienced decannulation or death, with distinct predictors for each outcome.

PMID:
42619359
Bibliographic data and abstract were imported from PubMed on 20 Aug 2026.

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