1 INTRODUCTION
Surgical tracheostomy (ST) is one of the most frequently performed
surgical procedures for patients with severe or critical
conditions.1 Similar to
any other invasive procedure, ST can result in numerous potential
complications. These include early complications, such as bleeding,
subcutaneous emphysema, stomal infection, and accidental
decannulation,2 and late
complications, such as airway stenosis, tracheomalacia, tracheocutaneous
fistula, and
pneumonia.1,2Postoperative complications of ST are rare, and the early and late
postoperative complication rates are 5.6% and 7.1%,
respectively.3 Obesity
and awake tracheostomy are major risk factors for postoperative
complications of
ST.4,5Further, four or more comorbidities are reported to increase the risk of
postoperative bleeding, which is the most frequent early complication of
ST.3,6Additionally, ST is sometimes necessary for patients undergoing
continued antithrombotic therapy (CAT), which can exacerbate the risk of
bleeding. However, there is a dearth of data regarding ST under CAT.
Several guidelines recommend that tooth extraction in patients on
antithrombotic therapy can be performed without reducing or
discontinuing antiplatelet or anticoagulant
drugs7-10 and that
percutaneous endoscopic
gastrostomy11 and
endoscopic variceal
ligation12 can be
performed without discontinuing aspirin. However, no established
guidelines are currently available for the
management
of antithrombotic therapy in patients undergoing ST. In this study, we
investigated the risk factors for
complications after ST by focusing on CAT use during ST.