title: Incidence of overall complications and symptomatic tracheal stenosis is equivalent following open and percutaneous tracheostomy in the trauma patient.
abstract: BACKGROUND
  While percutaneous tracheostomy (PT) is becoming the procedure of choice for elective tracheostomy, there is little late complication data. This study compared incidence of, and factors contributing to, tracheal stenosis following PT or open tracheostomy (OT).
  
  
  METHODS
  A 10-year review was conducted of trauma patients undergoing tracheostomy. Data on demographics, injury severity, tracheostomy type, complications, and outcomes were compared between patients receiving PT or OT and for those with or without tracheal stenosis.
  
  
  RESULTS
  Of 616 patients, 265 underwent OT and 351 underwent PT. Median injury severity score was higher for PT (26 vs 24, P = .010). Overall complication rate was not different (PT = 2.3% vs OT = 2.6%, P = .773). There were 9 tracheal stenosis, 4 (1.1%) from the PT group and 5 (1.9%) from the OT group (P = .509). Mortality was higher in OT patients (15.5% vs 9.7%, P = .030). Patients developing tracheal stenosis were younger (29.8 vs 45.2 years, P = .021) and had a longer intensive care unit length of stay (28.3 vs 18.9 days, P = .036).
  
  
  CONCLUSIONS
  Risk of tracheal stenosis should not impact the decision to perform an OT or PT.
authors.affiliation: Department of Surgery, The University of Kansas School of Medicine - Wichita, 929 N. Saint Francis Street, Room 3082, Wichita, KS 67214, USA.
authors.forename: William W
authors.initials: WW
authors.lastname: Kettunen
authors.affiliation: Department of Surgery, The University of Kansas School of Medicine - Wichita, 929 N. Saint Francis Street, Room 3082, Wichita, KS 67214, USA.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Helmer
authors.affiliation: Department of Surgery, The University of Kansas School of Medicine - Wichita, 929 N. Saint Francis Street, Room 3082, Wichita, KS 67214, USA; Department of Trauma Services, Via Christi Hospital, Saint Francis Campus, Wichita, KS, USA. Electronic address: James.Haan.Research@viachristi.org.
authors.forename: James M
authors.initials: JM
authors.lastname: Haan
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014135:Tracheal Stenosis / Q000453:epidemiology / Q000209:etiology*; D014139:Tracheostomy / Q000379:methods*; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000601:surgery*
keywords: Open tracheostomy; Percutaneous tracheostomy; Tracheal stenosis