DOI QR코드

DOI QR Code

Analysis of morbidity, mortality, and risk factors of tracheostomy-related complications in patients with oral and maxillofacial cancer

  • Lee, Seung Tae (Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center) ;
  • Kim, Min Gyun (Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center) ;
  • Jeon, Jae Ho (Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center) ;
  • Jeong, Joo Hee (Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center) ;
  • Min, Seung Ki (Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center) ;
  • Park, Joo Yong (Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center) ;
  • Choi, Sung Weon (Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center)
  • Received : 2016.06.30
  • Accepted : 2016.08.11
  • Published : 2016.12.31

Abstract

Background: This study aimed to analyze and describe the morbidity and mortality associated with tracheostomy in patients with oral cancer and to identify the risk factors associated with tracheostomy complications. Methods: We performed a retrospective chart review of patients who underwent tracheostomy during a major oral cancer resection between March 2001 and January 2016 at the National Cancer Center, Korea. Overall, we included 51 patients who underwent tracheostomy after oral cancer surgery. We assessed the morbidity and mortality of tracheostomy and determined the risks associated with tracheostomy complications. Results: Twenty-two tracheostomy-related complications occurred in 51 patients. The morbidity and mortality rates were 35.2 % (n = 18) and 0 % (n = 0), respectively. Tracheostomy-related complications were tracheitis (n = 4), obstructed tracheostomy (n = 9), displaced tracheostomy (n = 5), air leakage (n = 1), stomal dehiscence (n = 1), and decannulation failure (n = 2). Most complications (19/22) occurred during the early postoperative period. Considering the risk factors for tracheostomy complications, the type of tube used was associated with the occurrence of tracheitis (p < 0.05). Additionally, body mass index and smoking status were associated with tube displacement (p < 0.05). However, no risk factors were significantly associated with obstructed tracheostomy. Conclusions: Patients with risk factors for tracheostomy complications should be carefully observed during the early postoperative period by well-trained medical staff.

Keywords

References

  1. Chew JY, Cantrell RW (1972) Tracheostomy: complications and their management. Arch Otolaryngol 96:538-45 https://doi.org/10.1001/archotol.1972.00770090816008
  2. Zeitouni AG, Kost KM (1994) Tracheostomy: a retrospective review of 281 cases. J Otolaryngol 23:61-6
  3. Berlauk JF (1986) Prolonged intubation vs. tracheostomy. Crit Care Med 14:742-5 https://doi.org/10.1097/00003246-198608000-00017
  4. Brantigan CO, Grow JB (1976) Cricothyrotomy: elective use in respiratory problems requiring tracheostomy. J ThoracCardiovasc Surg 71:72-81
  5. Hudak M, Hickey MM (2008) Nursing management of the patient with a tracheostomy. In: Myers EM, Johnson JT (eds) Tracheotomy: airway management, communication, and swallowing, 2nd edn. Plural Publishing Inc, California, pp 147-68
  6. Burns SM, Spilman M, Wilmoth D et al (1998) Are frequent inner cannula changes necessary? A pilot study. Heart Lung 27:58-62 https://doi.org/10.1016/S0147-9563(98)90070-X
  7. Alberti PW (1984) Tracheostomy versus intubation: a 19th century controversy. Ann Otol Rhinol Laryngol 93:333-7 https://doi.org/10.1177/000348948409300410
  8. Castling B, Telfer M, Avery BS (1994) Complications of tracheostomy in major head and neck cancer surgery: a retrospective study of 60 consecutive cases. Br J Oral Maxillofac Surg 32:3-5 https://doi.org/10.1016/0266-4356(94)90162-7
  9. Waldron J, Padgham ND, Hurley SE (1990) Complications of emergency and elective tracheostomy: a retrospective study of 150 cases. Ann R CollSurg Engl 15:363-6
  10. Burke A (1981) The advantages of stay sutures with tracheostomy. Ann R Coll Surg Engl 63:426-8
  11. Myers EN, Suen JY (1989) Cancer of the head and neck, 2nd edn. Churchill Livingstone, Edinburgh, pp 972-5
  12. Sherman JM, Davis S, Albamonte-Petrick S et al (2000) Care of the child with a chronic tracheostomy. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. Am J Respir Crit Care Med 161:297-308 https://doi.org/10.1164/ajrccm.161.1.ats1-00
  13. Husein OF, Massick DD (2005) Cricoid palpability as a selection criterion for bedside tracheostomy. Otolaryngol Head Neck Surg 133:839-44 https://doi.org/10.1016/j.otohns.2005.08.008
  14. Ghorayeb BY (1987) Tracheotomy in the morbidly obese patient. Arch Otolaryngol Head Neck Surg 113:556-8 https://doi.org/10.1001/archotol.1987.01860050102026
  15. Harris AT, Morell D, Bajaj Y, Martin-Hirsch DP (2010) A discussion of airway and respiratory complications along with general considerations in obese patients. Int J Clin Pract 64:802-6 https://doi.org/10.1111/j.1742-1241.2010.02350.x
  16. El-Solh AA (2004) Clinical approach to the critically ill, morbidly obese patient. Am J Resp Crit Care Med 169:557-61 https://doi.org/10.1164/rccm.200309-1256CC

Cited by

  1. Analysis of the outcome of young age tongue squamous cell carcinoma vol.39, pp.39, 2016, https://doi.org/10.1186/s40902-017-0139-8