Is Continued Perioperative Antithrombotic Therapy Safe When Performing Open Tracheostomy?

Area of Science:

• Cardiovascular Medicine
• Surgical Innovation
• Patient Safety

Background:

• Open tracheostomy lacks specific guidelines for antithrombotic therapy (ATT) management.
• ATT encompasses both anticoagulation and antiplatelet medications.
• Evaluating perioperative ATT's impact on complications is crucial.

Purpose of the Study:

• To assess the influence of perioperative antithrombotic medication on open tracheostomy complications.
• To determine if ATT use affects perioperative or postoperative outcomes.

Main Methods:

• Retrospective review of 217 open tracheostomies (Jan 2015-Dec 2019).
• Analysis of patient demographics, comorbidities, ATT status, operative details, and complications.
• Comparison of outcomes between patients on ATT and those not on ATT.

Main Results:

• No significant difference in perioperative or postoperative bleeding between ATT and non-ATT groups.
• ATT patients showed a trend towards higher 30-day mortality (P=0.035).
• Hemorrhage-related deaths were low and mostly unrelated to tracheostomy in both groups.

Conclusions:

• Perioperative antithrombotic therapy use appears safe for open tracheostomy.
• Continued ATT is feasible without significantly increasing bleeding risks.
• Further research may clarify mortality risks in ATT patients undergoing tracheostomy.