A multi-institutional analysis of tracheotomy complications

Stacey L. Halum, Jonathan Y. Ting, Emily K. Plowman, Peter C Belafsky, Claude F. Harbarger, Gregory N. Postma, Michael J. Pitman, Donna Lamonica, Augustine Moscatello, Sid Khosla, Christy E. Cauley, Nicole C. Maronian, Sami Melki, Cameron Wick, John T. Sinacori, Zrria White, Ahmed Younes, Dale C. Ekbom, Maya G. Sardesai, Albert L. Merati

Research output: Contribution to journalArticle

107 Citations (Scopus)

Abstract

Objectives/Hypothesis: To define the prevalence of tracheotomy tube complications and evaluate risk factors (RFs) associated with their occurrence. Study Design: Multi-institution historical cohort. Methods: Data regarding tracheotomy tube complications from consecutive surgeries performed across eight participating institutions between January 1, 2008 and December 31, 2009 were retrospectively collected. Patient demographics, comorbidities, physician specialty, and surgical technique were recorded and statistically analyzed to identify the incidence of surgical complications following tracheotomy and associated RFs. Results: The charts of 1,175 tracheotomy procedures were reviewed from eight academic institutions. Otolaryngologists performed 66.2% of the tracheotomies. Intraoperative, early (<1 week), and late complication rates were 1.4%, 5.6%, and 7.1%, respectively. Postoperative bleeding was identified as the most common early complication (2.6%), whereas airway stenosis was the most common late complication (1.7%). The use of outer flange security sutures to anchor the tracheostomy tube was negatively associated with the incidence of early complication (P <.0001). The use of large endotracheal tubes (size >7.5) and obesity were associated with the development of airway stenosis (P <.05).Twenty-two percent of patients undergoing tracheotomy died during hospitalization. Conclusions: Perioperative tracheotomy complications are rare; however, the rate of death for all causes is high (22%) in this population. Obesity and the use of endotracheal tubes over 7.5 in size are major risk factors for the development of airway stenosis. Although percutaneous tracheotomy resulted in a significantly higher rate of postoperative bleeding (6.6%) than the open method (1.9%) (P <.05), the use of outer flange tracheostomy tube sutures may reduce this complication.

Original languageEnglish (US)
Pages (from-to)38-45
Number of pages8
JournalLaryngoscope
Volume122
Issue number1
DOIs
StatePublished - Jan 2012

Fingerprint

Tracheotomy
Pathologic Constriction
Obesity
Surgical Specialties
Tracheostomy
Sutures
Comorbidity
Cause of Death
Hospitalization
Demography
Hemorrhage
Physicians
Mortality
Incidence

Keywords

  • complications
  • open tracheotomy
  • percutaneous tracheotomy
  • tracheostomy
  • tracheostomy tube
  • Tracheotomy

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Halum, S. L., Ting, J. Y., Plowman, E. K., Belafsky, P. C., Harbarger, C. F., Postma, G. N., ... Merati, A. L. (2012). A multi-institutional analysis of tracheotomy complications. Laryngoscope, 122(1), 38-45. https://doi.org/10.1002/lary.22364

A multi-institutional analysis of tracheotomy complications. / Halum, Stacey L.; Ting, Jonathan Y.; Plowman, Emily K.; Belafsky, Peter C; Harbarger, Claude F.; Postma, Gregory N.; Pitman, Michael J.; Lamonica, Donna; Moscatello, Augustine; Khosla, Sid; Cauley, Christy E.; Maronian, Nicole C.; Melki, Sami; Wick, Cameron; Sinacori, John T.; White, Zrria; Younes, Ahmed; Ekbom, Dale C.; Sardesai, Maya G.; Merati, Albert L.

In: Laryngoscope, Vol. 122, No. 1, 01.2012, p. 38-45.

Research output: Contribution to journalArticle

Halum, SL, Ting, JY, Plowman, EK, Belafsky, PC, Harbarger, CF, Postma, GN, Pitman, MJ, Lamonica, D, Moscatello, A, Khosla, S, Cauley, CE, Maronian, NC, Melki, S, Wick, C, Sinacori, JT, White, Z, Younes, A, Ekbom, DC, Sardesai, MG & Merati, AL 2012, 'A multi-institutional analysis of tracheotomy complications', Laryngoscope, vol. 122, no. 1, pp. 38-45. https://doi.org/10.1002/lary.22364
Halum SL, Ting JY, Plowman EK, Belafsky PC, Harbarger CF, Postma GN et al. A multi-institutional analysis of tracheotomy complications. Laryngoscope. 2012 Jan;122(1):38-45. https://doi.org/10.1002/lary.22364
Halum, Stacey L. ; Ting, Jonathan Y. ; Plowman, Emily K. ; Belafsky, Peter C ; Harbarger, Claude F. ; Postma, Gregory N. ; Pitman, Michael J. ; Lamonica, Donna ; Moscatello, Augustine ; Khosla, Sid ; Cauley, Christy E. ; Maronian, Nicole C. ; Melki, Sami ; Wick, Cameron ; Sinacori, John T. ; White, Zrria ; Younes, Ahmed ; Ekbom, Dale C. ; Sardesai, Maya G. ; Merati, Albert L. / A multi-institutional analysis of tracheotomy complications. In: Laryngoscope. 2012 ; Vol. 122, No. 1. pp. 38-45.
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AU - Ting, Jonathan Y.

AU - Plowman, Emily K.

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AU - Harbarger, Claude F.

AU - Postma, Gregory N.

AU - Pitman, Michael J.

AU - Lamonica, Donna

AU - Moscatello, Augustine

AU - Khosla, Sid

AU - Cauley, Christy E.

AU - Maronian, Nicole C.

AU - Melki, Sami

AU - Wick, Cameron

AU - Sinacori, John T.

AU - White, Zrria

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KW - complications

KW - open tracheotomy

KW - percutaneous tracheotomy

KW - tracheostomy

KW - tracheostomy tube

KW - Tracheotomy

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