COLOGNE. A tracheotomy can be associated with fatal complications for the patient. Eckard Klemm and Andreas Nowak investigated the causes and rates of deaths due to this intervention. They present the results of their study in the current issue of the Deutsches Ärzteblatt International (Dtsch Arztebl Int 2017; 114: 273-9).
For their analysis, the authors reviewed relevant publications from the past 25 years. They evaluated data on open surgical tracheotomy (OCT) as well as percutaneous dilational tracheotomy (PCT). Of some 25,000 tracheotomies described, 16,800 were PCT and 8,000 OCT. In total, 352 deaths were reported. The death rate was similar for both procedures (OCT: 0.62%, 95% confidence interval [0.47; 0.82]; PCT 0.67% [0.56; 0.81]). The most common causes of death relative to the total numbers were hemorrhage, loss of airway, and misplacement of the tube into a false passage.
Tracheotomies are among the most common procedures in ventilated patients in intensive care. In the US alone, an estimated 500 patients die every year or go on to experience long-term impairments as a result of a tracheotomy. Careful training under instruction by experienced physicians and using the World Health Organization's surgical safety checklist may help prevent tracheotomy-associated deaths, say the authors.