Complications and 30‐day hospital readmission rates of patients undergoing tracheostomy: A prospective analysis

Spataro, Emily A.; Durakovic, Nedim; Kallogjeri, Dorina; Nussenbaum, Brian

doi:10.1002/lary.26668

Cited by 50 publications

(40 citation statements)

References 29 publications

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“…There is heterogeneity among tracheotomy complication rates reported in the literature, as well as how complications are identified and categorized. Complication rates range from 0% to 40% for PDT and 7% to 58% for open tracheotomies . Only 10 (1%) of patients in our cohort experienced major complications, the most common of which was major bleeding requiring surgical intervention.…”

Section: Discussionmentioning

confidence: 84%

The safety and efficacy of open bedside tracheotomy: A retrospective analysis of 1000 patients

et al. 2019

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Objectives: To evaluate the safety/efficacy of performing open bedside tracheotomy (OBT) in intensive care unit (ICU) patients and identify predictive factors for outcomes.Methods: This is a retrospective cohort study. We identified 1000 consecutive patients undergoing OBT at a single university hospital starting from August 1, 2007. Complication rate, 30-day mortality, decannulation rate, time to surgery (TTS) from initial consult, and ICU length of stay were analyzed. Multivariate analysis was performed to identify predictors of complication rate, 30-day mortality, and decannulation rate.Results: Mean TTS was 1.80 days. Major complication rate was 1%. No intraoperative deaths were caused by tracheotomy although two deaths resulted from late tracheotomy-related complications. Thirty-day mortality was 26.6%. The only significant predictor for overall complications was mild chronic hepatitis (OR = 2.355). Predictors for 30-day mortality included platelet count <50,000 (OR = 2.125) and vasopressor use (OR = 3.51). Each additional year of age was associated with decreased decannulation rate (OR = 0.972).Conclusions: This study demonstrates the safety and efficacy of starting an OBT program in a highly comorbid population without strict selection criteria. Safety of OBT was supported by minimal major complication rates and no intraoperative tracheotomy-related deaths in our cohort. These complication rates were comparable to, or lower than, published studies of open and percutaneous techniques. Predictive factors for decannulation, complication, and mortality were identified to help determine which patients would benefit from OBT.

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Section: Discussionmentioning

confidence: 84%

The safety and efficacy of open bedside tracheotomy: A retrospective analysis of 1000 patients

et al. 2019

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“…The overall postoperative complication rate for our cohort was 20.9%, which is slightly lower than the range (21.5%-47%) reported in the literature. 11,20 Analysis did not reveal any significant differences in complication rates when categorized by WHO classification subgroups. This may be limited by the relatively small size of each subgroup.…”

Section: Discussionmentioning

confidence: 75%

Postoperative Complications in Obese Patients After Tracheostomy

et al. 2020

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Objective To determine the prevalence of varying classes of obesity in patients undergoing tracheostomy and the associated complication rates as compared with nonobese patients. Study Design A retrospective chart review was performed from 2012 to 2018 on all patients who underwent open tracheostomy by the Department of Otolaryngology–Head and Neck Surgery. Setting All tracheostomies were performed at a single tertiary care center. Methods Patients were classified by body mass index (BMI) according to the World Health Organization classification system: underweight (<18.5), normal-overweight (18.5-29.9), class I (30-34.9), class II (35-39.9), and class III (>40). Charts were reviewed for patient demographic information, Charlson Comorbidity Index score, surgical indication, operative time, tracheostomy tube type, and postoperative complications. Results A total of 387 patients (mean ± SD BMI, 31.3 ± 14.2) were identified per the inclusion/exclusion criteria. Of patients with BMI >30 (n=153), 34.6% were categorized as obesity class I, 29.4% as class II, and 35.9% as class III. The most common indication for tracheostomy was malignancy in nonobese patients (41.5%) and respiratory failure for obese patients (58.2%). Operative time was significantly longer in obese patients, and most of these patients required an extended-length tracheostomy tube. Patients with a BMI >40 had higher rates of multiple postoperative complications or death ( P = .009). Underweight patients also had a higher rate of complication than normal-overweight patients ( P = .016). Conclusion Class III and underweight patients had higher rates of postoperative complications, which should be taken into consideration during perioperative counseling.

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“…Early complications include obstruction of the tube and pneumothorax or subcutaneous emphysema. Late complications include tracheal stenosis, ulceration around the trachea tube or fistula formation, decreased ability to speak, and readmission (60,61,62).…”

Section: Resultsmentioning

confidence: 99%

The impact of Pompe disease on smooth muscle: a review

McCall

Salemi

Bhanap

et al. 2018

J. Smooth Muscle Res.

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Pompe disease (OMIM 232300) is an autosomal recessive disorder caused by mutations in the gene encoding acid α-glucosidase (GAA) (EC 3.2.1.20), the enzyme responsible for hydrolyzing lysosomal glycogen. The primary cellular pathology is lysosomal glycogen accumulation in cardiac muscle, skeletal muscle, and motor neurons, which ultimately results in cardiorespiratory failure. However, the severity of pathology and its impact on clinical outcomes are poorly described in smooth muscle. The advent of enzyme replacement therapy (ERT) in 2006 has improved clinical outcomes in infantile-onset Pompe disease patients. Although ERT increases patient life expectancy and ventilator free survival, it is not entirely curative. Persistent motor neuron pathology and weakness of respiratory muscles, including airway smooth muscles, contribute to the need for mechanical ventilation by some patients on ERT. Some patients on ERT continue to experience life-threatening pathology to vascular smooth muscle, such as aneurysms or dissections within the aorta and cerebral arteries. Better characterization of the disease impact on smooth muscle will inform treatment development and help anticipate later complications. This review summarizes the published knowledge of smooth muscle pathology associated with Pompe disease in animal models and in patients.

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Complications and 30‐day hospital readmission rates of patients undergoing tracheostomy: A prospective analysis

Abstract: 2b. Laryngoscope, 127:2746-2753, 2017.

Cited by 50 publications

References 29 publications

The safety and efficacy of open bedside tracheotomy: A retrospective analysis of 1000 patients

The safety and efficacy of open bedside tracheotomy: A retrospective analysis of 1000 patients

Postoperative Complications in Obese Patients After Tracheostomy

The impact of Pompe disease on smooth muscle: a review

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