Tracheostomy complications in otorhinolaryngology are rare despite the critical airway

Eur Arch Otorhinolaryngol. 2021 Nov;278(11):4519-4523. doi: 10.1007/s00405-021-06707-7. Epub 2021 Mar 3.

Abstract

Purpose: To identify complications of surgical tracheostomies in otorhinolaryngologic patients and adjust our processes to be properly prepared in the future.

Methods: We reviewed retrospectively all surgical tracheostomies (n = 255) performed by otolaryngologist-head and neck surgeons at Helsinki University Hospital between Jan 2014 and Feb 2017. Patient demographics, surgical details, surgical and medical complications, and tracheostomy-related mortality were recorded from the hospital charts. Risk factors for complications were assessed.

Results: Altogether, 55 (22%) complications were identified in 39 (15%) patients, with pneumonia, accidental decannulation, and bleeding being the most common. No patient or surgery-related factor reached significance in overall complication risk factor analysis. Medical complications were more common after elective tracheostomies compared to emergency procedures (10.6% vs. 3.5%, p < 0.05). Majority of complications (78%) were classified as mild or moderate according to Clavien-Dindo. Only 2 (0.8%) tracheostomy-related deaths were recorded.

Conclusion: In otorhinolaryngologists service, severe complications and tracheostomy-related deaths are very rare. Reducing their prevalence even further with careful planning is possible.

Keywords: Airway; ENT; Morbidity; Mortality; Tracheostomy; Tracheotomy.

MeSH terms

  • Humans
  • Otolaryngologists
  • Otolaryngology*
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Tracheostomy* / adverse effects