Safety of surgical tracheostomy under continued antithrombotic therapy: A retrospective cohort study

Sugaya, Takayuki; Ueha, Rumi; Sato, Taku; Goto, Takao; Yamauchi, Akihito; Yamasoba, Tatsuya

doi:10.1111/coa.13861

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…We considered the presence of bleeding and infection as possible postoperative complications of interest. The postoperative period was defined as the interval between the date of surgery and the seventh postoperative day, following a previous rationale 22 . We defined “bleeding” as bleeding lasting 7 days after APS or bleeding requiring compression or surgical hemostasis and “infection” as a condition including anastomotic leakage requiring additional antibiotic administration or surgical treatment such as excision of the infected area and revision APS.…”

Section: Methodsmentioning

confidence: 99%

Aspiration Prevention Surgery: Clinical Factors Associated With Improvements in Oral Status Intake and Suction Frequency

Koyama

Ueha

Sato

et al. 2023

Otolaryngol.--head neck surg.

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Objective In recent years, the use of aspiration prevention surgery (APS) for the treatment of severe dysphagia has been on the rise. However, relevant clinical studies have included small samples, and the frequency of, and risk factors for postoperative complications have not been clarified. We investigated the clinical features of patients undergoing APS and whether oral‐intake status and suction frequency could be reduced. Study Design A case series. Setting Single‐institution academic center. Methods We retrospectively evaluated medical charts generated from 2010 to 2021. The clinical characteristics of patients undergoing APS, changes in the oral‐intake status (Functional Oral Intake Scale, FOIS), suction frequency before and after surgery, risk factors for postoperative complications, and factors contributing to improvements in postoperative oral‐intake status were retrieved. Results We included the data of 100 patients (median age: 65 years, 72 men). Amyotrophic lateral sclerosis was the most common primary disease (28%), and glottis closure was the most common APS (69%). Postoperatively, 78% of patients showed improvements in the FOIS score, and suction frequency decreased in 85% of cases. Postoperative complications were observed in 10 patients (10%), wound infection in 6, and bleeding in 4; all improved. Higher preoperative FOIS scores were significantly associated with postoperative complications (p = 0.02). Conclusion APS contributed to improving the FOIS score and helped reduce the suction frequency in most cases. APS can be performed safely with proper perioperative management, even in patients with poor preoperative general conditions and nutritional status.

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Section: Methodsmentioning

confidence: 99%

Aspiration Prevention Surgery: Clinical Factors Associated With Improvements in Oral Status Intake and Suction Frequency

Koyama

Ueha

Sato

et al. 2023

Otolaryngol.--head neck surg.

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“…20 The ORT group is disproportionately smaller due to increased provider preference for OBT since the implementation of the OBT program in 2016. However, the rates of the safety of ORT are well-established by multiple studies, [23][24][25][26] and the primary purpose of this study was not to evaluate the safety or outcomes of ORT but rather to demonstrate OBT in this community setting are comparable. The performing surgeon was not controlled for within or across tracheostomy location groups, and the data may not account for variations in certain practice patterns across different providers.…”

Section: Limitationsmentioning

confidence: 99%

Creation of an Open Bedside Tracheostomy Program at a Community Hospital With a Single Surgeon

et al. 2023

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Objective To assess the adverse event rate and operating cost of open bedside tracheostomy (OBT) at a community hospital. To present a model for creating an OBT program at a community hospital with a single surgeon. Study Design Retrospective case series pilot study. Setting Academic‐affiliated community hospital. Methods Retrospective chart review of surgical OBT and operating room tracheostomy (ORT) at a community hospital from 2016 to 2021. Primary outcomes included operation duration; perioperative, postoperative, and long‐term complications; and crude time‐based estimation of operating cost to the hospital using annual operating cost. Clinical outcomes of OBT were assessed with ORT as a comparison using t tests and Fisher's exact tests. Results Fifty‐five OBT and 14 ORT were identified. Intensive care unit (ICU) staff training in preparing for and assisting with OBT was successfully implemented by an Otolaryngologist and ICU nursing management. Operation duration was 20.3 minutes for OBT and 25.2 minutes for ORT ( p = .14). Two percent, 18%, and 10% of OBT had perioperative, postoperative, and long‐term complications, respectively; this was comparable to rates for ORT ( p = .10). The hospital saved a crude estimate of $1902 in operating costs per tracheostomy when performed in the ICU. Conclusion An OBT protocol can be successfully implemented at a single‐surgeon community hospital. We present a model for creating an OBT program at a community hospital with limited staff and resources.

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Safety of surgical tracheostomy under continued antithrombotic therapy: A retrospective cohort study

Cited by 2 publications

References 18 publications

Aspiration Prevention Surgery: Clinical Factors Associated With Improvements in Oral Status Intake and Suction Frequency

Aspiration Prevention Surgery: Clinical Factors Associated With Improvements in Oral Status Intake and Suction Frequency

Creation of an Open Bedside Tracheostomy Program at a Community Hospital With a Single Surgeon

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