A multi-institutional analysis of tracheotomy complications

Area of Science:

• Otolaryngology
• Surgical Complications
• Patient Safety

Background:

• Tracheotomy is a common procedure with potential complications.
• Understanding the incidence and risk factors for these complications is crucial for improving patient outcomes.

Purpose of the Study:

• To determine the prevalence of tracheotomy tube complications.
• To identify risk factors associated with tracheotomy complications.

Main Methods:

• Retrospective cohort study of 1,175 tracheotomy procedures across eight institutions.
• Data collected on patient demographics, comorbidities, and surgical techniques.
• Statistical analysis to identify incidence and risk factors of complications.

Main Results:

• Overall complication rates: intraoperative 1.4%, early 5.6%, late 7.1%.
• Most common early complication: postoperative bleeding (2.6%).
• Most common late complication: airway stenosis (1.7%).
• High all-cause mortality rate of 22% in hospitalized patients.
• Obesity and large endotracheal tubes (>7.5) linked to airway stenosis.
• Security sutures associated with reduced early complications.
• Percutaneous tracheotomy had higher bleeding rates than open tracheotomy.

Conclusions:

• Perioperative tracheotomy complications are rare, but mortality is significant.
• Obesity and large endotracheal tubes are key risk factors for airway stenosis.
• Tracheostomy tube security sutures may mitigate bleeding complications.