Confirmation of no causal relationship between tracheotomy and aspiration status: a direct replication study

Debate continues regarding an association between tracheotomy and aspiration status. The aim of this research was to perform a direct replication study to investigate further the causal relationship, if any, between tracheotomy and aspiration. Twenty-five consecutive adult hospitalized patients participated. Inclusion criteria were a pretracheotomy dysphagia evaluation, subsequent tracheotomy and tracheotomy tube placement, then a post-tracheotomy dysphagia reevaluation prior to decannulation. Twenty-two (88%) participants exhibited the same aspiration status or resolved aspiration pre- versus post-tracheotomy. Three participants exhibited new aspiration post-tracheotomy due to worsening medical conditions. Conversely, four participants exhibited resolved aspiration post-tracheotomy due to improved medical conditions. Excluding these seven participants, all nine participants who aspirated pretracheotomy also aspirated post-tracheotomy and all nine participants who did not aspirate pretracheotomy also did not aspirate post-tracheotomy (P > 0.05). No statistically significant differences were found between aspiration status and days since tracheotomy (chi (2) = 0.08, P > 0.05) or between age and aspiration status (P > 0.05). The absence of a causal relationship between tracheotomy and aspiration status was confirmed.