Investigation of Management of Tracheostomy Tube and Mortality at an Acute-care General Hospital

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  • Hanada Yukiko
    Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine
  • Ogawa Makoto
    Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine
  • Hosokawa Kiyohito
    Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine
  • Shikina Takashi
    Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine
  • Inohara Hidenori
    Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine
  • Nagai Miki
    Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Hospital
  • Uetsuka Satoru
    Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Hospital
  • Sakata Yoshiharu
    Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Hospital
  • Sasai Hisanori
    Department of Otorhinolaryngology-Head and Neck Surgery, Kansai Rosai Hospital
  • Miyahara Hiroshi
    Department of Pharmacy, Yasuda Women's University

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Other Title
  • 急性期病院における気管切開術の術後経過に関する臨床的検討
  • キュウセイキ ビョウイン ニ オケル キカン セッカイジュツ ノ ジュツゴ ケイカ ニ カンスル リンショウテキ ケントウ

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Tracheostomy is a common surgical procedure performed by the otolaryngologist. However, very few reports exist concerning long-term decannulation and survival rates following tracheostomy. The aim of this study was to investigate the association between long-term outcomes of patients who underwent a tracheostomy and the causal diseases at an acute-care general hospital retrospectively. The subjects were 214 (155 male and 59 female) cases who underwent a tracheo-stomy during admission. The state of the tracheostomy tube and mortality were assessed for each case every 4 weeks until 24 weeks after the operation. Decannulation and mortality rates were compared among the causal diseases. The decannulation rate in all cases increased to a plateau of 31.8% 12 weeks after the operation. In an investigation of the individual groups, the group of cases with head and neck diseases, for which tracheostomy was performed because of unstable airway, achieved a 50%decannulation rate. The groups with cases of cardiac, respiratory, or gastrointestinal diseases, for which tracheostomy was performed because of prolonged mechanical ventilation, showed 31.8%,27.7% and 23.1% decannulation rates, respectively. The group of cases with neurological diseases included more than 40% of cases transferred to other chronic-care institutes with unknown outcome. In conclusion, these findings suggest that decannulation and mortality rates in tracheostomized cases at an acute-care hospital are dependent on the causal diseases and indications of the tracheostomy.

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