Tracheostomy outcomes and perioperative management in a Danish secondary care ENT department

Tracheostomy is widely used in critically ill patients, yet limited clinical data exist from Danish ENT departments.

To describe clinical outcomes and perioperative care in patients undergoing tracheostomy at a secondary ENT department in Denmark.

This retrospective cohort study included all adult patients who underwent tracheostomy at Gødstrup Hospital between 2019 and 2024. Data were extracted from electronic records. Postoperative pneumonia was the primary outcome; secondary outcomes included perioperative care assessment and in-hospital mortality.

Seventy-seven patients were included, of whom 71 were evaluable for pneumonia outcome. Postoperative pneumonia occurred in 63% of patients. Neurological comorbidity was more frequent among patients with pneumonia (31% versus 8%, p = 0.037). Prophylactic antibiotics alone did not reduce pneumonia rates (61% versus 67%, p = 0.81). Postoperative dysphagia screening, pulmonary physiotherapy, and dietetic referral were more common in patients with pneumonia. In-hospital mortality was 14%, primarily in patients with prolonged intubation due to non-ENT causes. No deaths were directly related to the procedure.

Postoperative pneumonia rates were high and associated with neurological comorbidity. Prophylactic antibiotics alone did not reduce pneumonia rates. These findings highlight the need for structured perioperative care in patients undergoing tracheostomy.