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Incidence of overall complications and symptomatic tracheal stenosis is equivalent following open and percutaneous tracheostomy in the trauma patient

2014; Elsevier BV; Volume: 208; Issue: 5 Linguagem: Inglês

10.1016/j.amjsurg.2013.12.036

1879-1883

William W. Kettunen, Stephen D. Helmer, James M. Haan,

Airway Management and Intubation Techniques

Background While percutaneous tracheostomy (PT) is becoming the procedure of choice for elective tracheostomy, there is little late complication data. This study compared incidence of, and factors contributing to, tracheal stenosis following PT or open tracheostomy (OT). Methods A 10-year review was conducted of trauma patients undergoing tracheostomy. Data on demographics, injury severity, tracheostomy type, complications, and outcomes were compared between patients receiving PT or OT and for those with or without tracheal stenosis. Results Of 616 patients, 265 underwent OT and 351 underwent PT. Median injury severity score was higher for PT (26 vs 24, P = .010). Overall complication rate was not different (PT = 2.3% vs OT = 2.6%, P = .773). There were 9 tracheal stenosis, 4 (1.1%) from the PT group and 5 (1.9%) from the OT group (P = .509). Mortality was higher in OT patients (15.5% vs 9.7%, P = .030). Patients developing tracheal stenosis were younger (29.8 vs 45.2 years, P = .021) and had a longer intensive care unit length of stay (28.3 vs 18.9 days, P = .036). Conclusion Risk of tracheal stenosis should not impact the decision to perform an OT or PT.