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.