AIM: To determine the incidence of pneumothorax after tracheostomy with a prospective study design. BACKGROUND: The incidence of post-tracheostomy pneumothorax in literature varies from 0 to 17%. All studies are of retrospective chart review design that can cause the selection bias. MATERIALS AND METHODS: Prospective, non-randomized study in a single tertiary hospital in Bangkok, Thailand. A total of 100 patients underwent tracheostomies between October 2012 and September 2013. Chest radiography was performed in each case post-operatively. The main outcome measurements were incidence of pneumothorax and complications. Patients were categorized as emergency surgery and patients with suspicious signs or symptoms after surgery, and were analyzed. RESULTS: In 100 tracheostomy cases, the overall complication rate was 14%. The most common complication was minor hemorrhage (4%), followed by major hemorrhage (3%). The overall incidence of pneumothorax was 1%. Subgroup analyses revealed a 20-fold higher incidence in emergency cases compared to the overall sample. CONCLUSIONS: With this prospective design study, we reported a 1% incidence of pneumothorax after tracheostomy. A routine post-operative chest radiograph is unnecessary. Emergency tracheostomy patients with suspicious signs or symptoms are at markedly increased risk and may benefit from a post-operative chest radiograph.
AIM: To determine the incidence of pneumothorax after tracheostomy with a prospective study design. BACKGROUND: The incidence of post-tracheostomy pneumothorax in literature varies from 0 to 17%. All studies are of retrospective chart review design that can cause the selection bias. MATERIALS AND METHODS: Prospective, non-randomized study in a single tertiary hospital in Bangkok, Thailand. A total of 100 patients underwent tracheostomies between October 2012 and September 2013. Chest radiography was performed in each case post-operatively. The main outcome measurements were incidence of pneumothorax and complications. Patients were categorized as emergency surgery and patients with suspicious signs or symptoms after surgery, and were analyzed. RESULTS: In 100 tracheostomy cases, the overall complication rate was 14%. The most common complication was minor hemorrhage (4%), followed by major hemorrhage (3%). The overall incidence of pneumothorax was 1%. Subgroup analyses revealed a 20-fold higher incidence in emergency cases compared to the overall sample. CONCLUSIONS: With this prospective design study, we reported a 1% incidence of pneumothorax after tracheostomy. A routine post-operative chest radiograph is unnecessary. Emergency tracheostomypatients with suspicious signs or symptoms are at markedly increased risk and may benefit from a post-operative chest radiograph.
Authors: Gabriel A Quiñones-Ossa; Y A Durango-Espinosa; H Padilla-Zambrano; Jenny Ruiz; Luis Rafael Moscote-Salazar; S Galwankar; J Gerber; R Hollandx; Amrita Ghosh; R Pal; Amit Agrawal Journal: J Neurosci Rural Pract Date: 2020-05-02