Pneumothorax after tracheostomy: A prospective study
Journal Title: Otolaryngologia Polska - Year 2015, Vol 69, Issue 3
Abstract
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.
Authors and Affiliations
Porawit Panajaroen, Napadon Tangjaturonrasme
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