Study Design, Patient Population, and Data Source
This single-center, retrospective cohort study included children with BPD and tracheostomies cared for at Cincinnati Children’s Hospital Medical Center (CCHMC) between January 2010 and December 2018. The study population was identified using existing internal tracheostomy and BPD registries; BPD diagnosis was additionally verified by the presence of relevant International Classification of Diseases diagnosis codes for BPD or chronic lung disease of infancy (BPD: ICD -9 770.7,ICD -10 P27.1, CLDI: ICD-9 770.7, ICD -10 P27.8). Inclusion criteria required at least 1 bacterial respiratory culture (tracheostomy aspirate or bronchoalveolar lavage) obtained in the 3 years following tracheostomy placement. Children with cystic fibrosis and those without follow-up data at 3 years were excluded. Detailed demographic, clinical, respiratory culture, and respiratory support data for all encounters were obtained from the electronic medical record (EMR). Culture data included details of Gram stain, semi-quantitative organism results, and specimen source. Dates of tracheostomy placement, and, if applicable, dates of death were also obtained. This study was approved by the CCHMC Institutional Review Board as exempt research.