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Published on: March 15, 2024
Surgical versus percutaneous tracheostomy: an evidence-based approach
Sotirios Pappas1, Pavlos Maragoudakis, Petros Vlastarakos
1General Hospital of Korinthos, Corinth, Greece.
Summary
The evidence quality for surgical (ST) versus percutaneous tracheostomy (PT) is low. Even higher-quality studies show conflicting results, making definitive clinical recommendations challenging.
Area of Science:
- Medical research methodology
- Surgical procedures
- Critical care medicine
Background:
- The selection between surgical tracheostomy (ST) and percutaneous tracheostomy (PT) often lacks robust evidence.
- Evaluating the quality of existing comparative studies is crucial for informed clinical decision-making.
Purpose of the Study:
- To assess the quality of evidence in published literature comparing surgical tracheostomy (ST) and percutaneous tracheostomy (PT).
Main Methods:
- A comprehensive MEDLINE search was conducted to identify relevant studies.
- 37 articles met inclusion criteria, with 35 undergoing detailed analysis.
- Evidence quality was classified using established grading systems (Type I-IV).
Main Results:
- No studies utilized Type I evidence; 37% were Type II, and 60% were Type III or IV.
- Among Type II evidence studies, 7 favored PT and 3 favored ST regarding complication rates.
- The majority of comparative studies on PT versus ST rely on lower levels of evidence (Type III/IV).
Conclusions:
- The current body of evidence comparing PT and ST is predominantly of low quality (Type III/IV).
- Even higher-quality evidence (Type II) yields controversial outcomes.
- Clinical claims favoring either ST or PT remain debatable due to insufficient high-quality evidence.
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