Retrospective analysis of open bedside tracheotomies in a German tertiary care university hospital.
J Craniomaxillofac Surg 2020;
49:140-145. [PMID:
33423892 DOI:
10.1016/j.jcms.2020.12.010]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 11/22/2020] [Accepted: 12/25/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE
Open surgical tracheotomy performed beside (STB) is a standardized procedure in critical ill patients. The aim of the study was to evaluate perioperative complications and the safety of STB in a tertiary care university hospital setting.
MATERIALS AND METHODS
Intra- and postoperative complications were retrospectively recorded and associations based on the evaluation of clinical and laboratory parameters were studied using regression analyses.
RESULTS
A total of 562 patients were included. Early tracheotomy shortened ventilation time after tracheotomy (ventilation before STB ≤ 5 days: mean 9.2 ± 9.1 days; ventilation before STB ≥ 6 days: mean 11.5 ± 10.5 days, p = 0.0001). Overall complications were found in 30/562 cases (5.3%), major complications in 12/562 cases (2.1%). Significant risk factors for overall tracheotomy related complications were higher body mass index (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.01-1.07, p = 0.02), lower CRP (OR 0.99, CI 0.99-1.00, p = 0.03), higher INR (OR 5.67, CI 1.27-25.34, p = 0.02), longer duration of operation (OR 1.03, CI 1.00-1.06, p = 0.04) and tracheotomy during extracorporeal membrane oxygenation (ECMO) support (OR 6.26, CI 1.21-32.44, p = 0.03).
CONCLUSION
STB represents a safe surgical procedure, also suitable for patients with an increased risk profile. Careful evaluation of individual risk factors should be favored to reduce procedure related complications.
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