Retrospective analysis of post-tracheostomy complications

Area of Science:

• Critical Care Medicine
• Surgical Outcomes
• Patient Safety

Background:

• Tracheostomy is a common procedure for prolonged mechanical ventilation.
• Factors influencing tracheostomy complications, readmissions, and mortality require elucidation.
• Severe comorbidities are prevalent in patients undergoing tracheostomy.

Purpose of the Study:

• To identify patient, disease, and surgical factors associated with 90-day tracheostomy complications.
• To determine predictors of 90-day readmissions after tracheostomy.
• To analyze factors linked to overall mortality within 90 days of tracheostomy.

Main Methods:

• Retrospective case series including 697 patients from 2011-2018.
• Analysis of demographic, disease, and operative details.
• Multivariable analysis to identify significant associations with outcomes.

Main Results:

• 10% of patients experienced 90-day tracheostomy-related complications, with hemorrhage being most common.
• Difficult tracheostomy placement was the only significant predictor of 90-day complications.
• 30-day mortality was 40%, highlighting the severity of illness in this patient population.

Conclusions:

• Tracheostomy complications, though infrequent, can be severe and require preparedness, particularly after difficult placements.
• High 30-day mortality underscores the need for multidisciplinary evaluation and careful consideration of tracheostomy candidacy.
• Palliative care consultation is recommended for appropriate patient selection.