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.