title: Tracheotomy outcomes and complications: a national perspective.
abstract: OBJECTIVE
  To provide national level data on frequency of tracheotomy and complication rate and in-hospital mortality following tracheotomy.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Retrospective cohort study using a public national database, the Nationwide Inpatient Sample, 2006.
  
  
  RESULTS
  There were 113,653 tracheotomies performed in patients 18 years or older in 2006. The overall complication rate was 3.2%, and the in-hospital mortality rate was 19.2%. The data suggest that in-hospital mortality is usually due to the underlying illness rather than the tracheotomy. Mortality was higher in patients older than 50 years, those with cardiac conditions, particularly congestive heart failure, those with public insurance, and patients in Northeast hospitals. Patients with neurologic conditions, trauma, and upper airway infection are more likely to survive to discharge. In-hospital mortality is slightly higher in nonteaching hospitals.
  
  
  CONCLUSIONS
  This database study determined baseline data for the rate of complications (3.2%) for patients undergoing tracheotomy; it showed that only 80% of adult patients who underwent tracheotomy in the United States survived to discharge. Patients located in the Northeast, patients more than 50 years old, and patients with cardiac conditions were at particularly high risk for mortality. This study provides normative data for these outcomes for patient counseling and planning future quality improvement initiatives in this patient population.
authors.affiliation: Division of Otolaryngology, Children's National Medical Center, George Washington University Medical School, Washington, DC 20010, USA. rshah@cnmc.org
authors.forename: Rahul K
authors.initials: RK
authors.lastname: Shah
authors.forename: Lina
authors.initials: L
authors.lastname: Lander
authors.forename: Jay G
authors.initials: JG
authors.lastname: Berry
authors.forename: Brian
authors.initials: B
authors.lastname: Nussenbaum
authors.forename: Albert
authors.initials: A
authors.lastname: Merati
authors.forename: David W
authors.initials: DW
authors.lastname: Roberson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D017052:Hospital Mortality; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D014140:Tracheotomy / Q000009:adverse effects* / Q000401:mortality*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult