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Influence of early elective tracheostomy on the incidence of postoperative complications in patients undergoing head and neck surgery

Authors :
Johannes Meier
Michael Wunschel
Anne Angermann
Tobias Ettl
Thomas Metterlein
Christoph Klingelhöffer
Torsten E. Reichert
Markus Ritzka
Source :
BMC Anesthesiology, Vol 19, Iss 1, Pp 1-6 (2019)
Publication Year :
2019
Publisher :
BMC, 2019.

Abstract

Abstract Background The incidence of postoperative complications after head and neck surgery is high. This study evaluated the influence of early elective tracheostomy on the incidence of postoperative pneumonia and delirium. Methods We reviewed the data of all patients who had undergone removal of an oropharyngeal tumor and microsurgical tissue transfer at our department in a two year period. Pearson’s Chi-squared test and the Fischer’s exact t-test were then used to measure the influence of patients’ preexisting conditions and risk factors and of early elective tracheostomy on the incidence of postoperative complications. Results In total, 47 cases were analyzed. Patients with an endotracheal tube were ventilated for a longer time (3.4 days vs. 1.5 days) and were transferred to the regular ward later (after 6.9 days vs. 4.7 days) than patients with tracheostomy. Only 1 (2.1%) of the patients with a tracheostomy developed pneumonia in contrast to 5 intubated patients (10.6%) and only 2 patients with a tracheostomy developed postoperative delirium (9.5%) in contrast to 8 intubated patients (30.8%). Conclusion Early primary tracheostomy in patients undergoing resection of oropharyngeal cancer seems to have numerous benefits, such as lower complication rates with regard to pneumonia and postoperative delirium and shorter duration of both mechanical ventilation and intensive care unit (ICU) stays. Further studies have to evaluate if these benefits also influence morbidity and mortality rates.

Details

Language :
English
ISSN :
14712253
Volume :
19
Issue :
1
Database :
Directory of Open Access Journals
Journal :
BMC Anesthesiology
Publication Type :
Academic Journal
Accession number :
edsdoj.3f13885335124036a15d6a242d1de24d
Document Type :
article
Full Text :
https://doi.org/10.1186/s12871-019-0715-9