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

Lee, Seung Tae; Kim, Min Gyun; Jeon, Jae Ho; Jeong, Joo Hee; Min, Seung Ki; Park, Joo Yong; Choi, Sung Weon

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.