A Retrospective Review of Open Tracheostomies at Grady Memorial Hospital By Emory Oral and Maxillofacial Surgery

A Retrospective Review of Open Tracheostomies at Grady Memorial Hospital by Emory Oral and Maxillofacial Surgery

 

Shaun Young, DMD

Gary Bouloux, MD

Shelly Abramowicz, DMD

Statement of problem:  The purpose of this study was to report our institution’s outcomes following open tracheostomies.  Additionally, our study examined the number of subjects who were discharged from the ICU or weaned off mechanical ventilation within five postoperative days.

Materials and Methods:  A retrospective analysis of subjects who had tracheostomies at Grady Memorial Hospital from 2008 to 2015 was conducted. Subject charts were reviewed. Predictor variables were demographic information, indications, intraoperative complications, postoperative complications, and disposition on post-op day 5.  Descriptive statistics were computed.

Results: A total of 115 subjects (mean age 72, range 20-85) were included. 104/115 (90.4%) of the subjects included in this study received open tracheostomies due to prolonged mechanical ventilation.  The two intraoperative complications (1.7%) consisted of a cardiac arrest with return of spontaneous circulation after ACLS and inability to initially access trachea.  There were four subjects (3.5%) with postoperative bleeding which was managed appropriately with surgicel packing. Two subjects (1.7%) died within five days postoperatively for reasons unrelated to the surgical tracheostomy.  64/115 (55.6%) of subjects were either discharged from the ICU or weaned off mechanical ventilation within 5 days postoperatively.

Conclusion: The results of this study indicate that open tracheostomies performed by Oral and Maxillofacial Surgery at Grady Memorial Hospital with proper resident training and supervision are safe and have few complications.  Our study also reveals that tracheostomies are successful in weaning patients off of mechanical ventilation and decreasing length of stay.

 

References:

 

Haspel et al. Retrospective Study of Tracheostomy Indications and perioperative Complications on Oral and Maxillofacial Surgery Service. JOMS. 2012

Rowshan. Surgical Tracheostomy.  Atlas of the Oral and Maxillofacial Surgery Clinics. 2010.