Percutaneous or surgical tracheostomy: A meta-analysis
OBJECTIVETo compare percutaneous with surgical tracheostomy using a meta-analysis of studies published from 1960 to 1996. DATA SOURCESPublications obtained through a MEDLINE data-base search with a Boolean combination (tracheostomy or tracheotomy) and complications, with constraints for human studie...
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| Veröffentlicht in: | Critical care medicine 1999-08, Vol.27 (8), p.1617-1625 |
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| creator | Dulguerov, Pavel Gysin, Claudine Perneger, Thomas V Chevrolet, Jean-Claude |
| description | OBJECTIVETo compare percutaneous with surgical tracheostomy using a meta-analysis of studies published from 1960 to 1996.
DATA SOURCESPublications obtained through a MEDLINE data-base search with a Boolean combination (tracheostomy or tracheotomy) and complications, with constraints for human studies and English language.
STUDY SELECTIONPublications addressing all peri- and postoperative complications. Studies limited to specific tracheostomy complications or containing insufficient details were excluded. Two authors independently selected the publications.
DATA EXTRACTIONA list of relevant surgical variables and complications was compiled. Complications were divided into peri- and postoperative groups and further subclassified into severe, intermediate, and minor groups. Because most studies of percutaneous tracheostomy were published after 1985, surgical tracheostomy studies were divided into two periods1960 to 1984 and 1985 to 1996. The articles were analyzed independently by three investigators, and rare discrepancies were resolved through discussion and data reexamination.
DATA SYNTHESISEarlier surgical tracheostomy studies (n = 17; patients, 4185) have the highest rates of both peri- (8.5%) and postoperative (33%) complications. Comparison of recent surgical (n = 21; patients, 3512) and percutaneous (n = 27; patients, 1817) tracheostomy trials shows that perioperative complications are more frequent with the percutaneous technique (10% vs. 3%), whereas postoperative complications occur more often with surgical tracheotomy (10% vs. 7%). The bulk of the differences is in minor complications, except perioperative death (0.44% vs. 0.03%) and serious cardiorespiratory events (0.33% vs. 0.06%), which were higher with the percutaneous technique. Heterogeneity analysis of complication rates shows higher heterogeneity in older and surgical trials.
CONCLUSIONSPercutaneous tracheostomy is associated with a higher prevalence of perioperative complications and, especially, perioperative deaths and cardiorespiratory arrests. Postoperative complication rates are higher with surgical tracheostomy. (Crit Care Med 1999; 27:1617-1625) |
| doi_str_mv | 10.1097/00003246-199908000-00041 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70007429</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70007429</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3301-514356cedbe3471aaa6ab77e0622ca711456d1c2ab5229779e9f6aca2dd5943e3</originalsourceid><addsrcrecordid>eNp1kUtPwzAMgCMEYmPwF1APiFshrzYLt2niJU2CA5wjN3VZIV1H0mravyfQ8bgQKYosfXbsz4QkjF4wqtUljUdwmadMa02nMUrjlWyPjFkmYsC12CdjSjVNhdRiRI5CeKWUyUyJQzJiVCqqlByT_BG97TtYYduHpPVJ6P1LbcElnQe7xDZ0bbO9SmZJgx2ksAK3DXU4JgcVuIAnu3dCnm-un-Z36eLh9n4-W6RWCMrSjEmR5RbLAoVUDAByKJRCmnNuQbHYT14yy6HIONdKadRVDhZ4WWZaChQTcj7UXfv2vcfQmaYOFp0bGjYqjq1knHZCpgNofRuCx8qsfd2A3xpGzacz8-3M_DgzX85i6unuj75osPyTOEiKwNkOgBDNVB5Wtg6_nJZMaRUxOWCb1nXow5vrN-jNEsF1S_PfysQHMWGCbg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70007429</pqid></control><display><type>article</type><title>Percutaneous or surgical tracheostomy: A meta-analysis</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>Dulguerov, Pavel ; Gysin, Claudine ; Perneger, Thomas V ; Chevrolet, Jean-Claude</creator><creatorcontrib>Dulguerov, Pavel ; Gysin, Claudine ; Perneger, Thomas V ; Chevrolet, Jean-Claude</creatorcontrib><description>OBJECTIVETo compare percutaneous with surgical tracheostomy using a meta-analysis of studies published from 1960 to 1996.
DATA SOURCESPublications obtained through a MEDLINE data-base search with a Boolean combination (tracheostomy or tracheotomy) and complications, with constraints for human studies and English language.
STUDY SELECTIONPublications addressing all peri- and postoperative complications. Studies limited to specific tracheostomy complications or containing insufficient details were excluded. Two authors independently selected the publications.
DATA EXTRACTIONA list of relevant surgical variables and complications was compiled. Complications were divided into peri- and postoperative groups and further subclassified into severe, intermediate, and minor groups. Because most studies of percutaneous tracheostomy were published after 1985, surgical tracheostomy studies were divided into two periods1960 to 1984 and 1985 to 1996. The articles were analyzed independently by three investigators, and rare discrepancies were resolved through discussion and data reexamination.
DATA SYNTHESISEarlier surgical tracheostomy studies (n = 17; patients, 4185) have the highest rates of both peri- (8.5%) and postoperative (33%) complications. Comparison of recent surgical (n = 21; patients, 3512) and percutaneous (n = 27; patients, 1817) tracheostomy trials shows that perioperative complications are more frequent with the percutaneous technique (10% vs. 3%), whereas postoperative complications occur more often with surgical tracheotomy (10% vs. 7%). The bulk of the differences is in minor complications, except perioperative death (0.44% vs. 0.03%) and serious cardiorespiratory events (0.33% vs. 0.06%), which were higher with the percutaneous technique. Heterogeneity analysis of complication rates shows higher heterogeneity in older and surgical trials.
CONCLUSIONSPercutaneous tracheostomy is associated with a higher prevalence of perioperative complications and, especially, perioperative deaths and cardiorespiratory arrests. Postoperative complication rates are higher with surgical tracheostomy. (Crit Care Med 1999; 27:1617-1625)</description><identifier>ISSN: 0090-3493</identifier><identifier>EISSN: 1530-0293</identifier><identifier>DOI: 10.1097/00003246-199908000-00041</identifier><identifier>PMID: 10470774</identifier><identifier>CODEN: CCMDC7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Adult ; Age Distribution ; Biological and medical sciences ; Child ; Cross Infection - etiology ; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics ; Heart Arrest - etiology ; Hemorrhage - etiology ; Humans ; Mediastinal Emphysema - etiology ; Medical sciences ; Middle Aged ; Patient Selection ; Pneumothorax - etiology ; Research Design ; Severity of Illness Index ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the upper aerodigestive tract ; Tracheoesophageal Fistula - etiology ; Tracheostomy - adverse effects ; Tracheostomy - methods ; Tracheostomy - mortality ; Tracheostomy - trends ; Tracheotomy - adverse effects ; Tracheotomy - methods ; Tracheotomy - mortality ; Tracheotomy - trends ; Treatment Outcome</subject><ispartof>Critical care medicine, 1999-08, Vol.27 (8), p.1617-1625</ispartof><rights>1999 Lippincott Williams & Wilkins, Inc.</rights><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3301-514356cedbe3471aaa6ab77e0622ca711456d1c2ab5229779e9f6aca2dd5943e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1941797$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10470774$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dulguerov, Pavel</creatorcontrib><creatorcontrib>Gysin, Claudine</creatorcontrib><creatorcontrib>Perneger, Thomas V</creatorcontrib><creatorcontrib>Chevrolet, Jean-Claude</creatorcontrib><title>Percutaneous or surgical tracheostomy: A meta-analysis</title><title>Critical care medicine</title><addtitle>Crit Care Med</addtitle><description>OBJECTIVETo compare percutaneous with surgical tracheostomy using a meta-analysis of studies published from 1960 to 1996.
DATA SOURCESPublications obtained through a MEDLINE data-base search with a Boolean combination (tracheostomy or tracheotomy) and complications, with constraints for human studies and English language.
STUDY SELECTIONPublications addressing all peri- and postoperative complications. Studies limited to specific tracheostomy complications or containing insufficient details were excluded. Two authors independently selected the publications.
DATA EXTRACTIONA list of relevant surgical variables and complications was compiled. Complications were divided into peri- and postoperative groups and further subclassified into severe, intermediate, and minor groups. Because most studies of percutaneous tracheostomy were published after 1985, surgical tracheostomy studies were divided into two periods1960 to 1984 and 1985 to 1996. The articles were analyzed independently by three investigators, and rare discrepancies were resolved through discussion and data reexamination.
DATA SYNTHESISEarlier surgical tracheostomy studies (n = 17; patients, 4185) have the highest rates of both peri- (8.5%) and postoperative (33%) complications. Comparison of recent surgical (n = 21; patients, 3512) and percutaneous (n = 27; patients, 1817) tracheostomy trials shows that perioperative complications are more frequent with the percutaneous technique (10% vs. 3%), whereas postoperative complications occur more often with surgical tracheotomy (10% vs. 7%). The bulk of the differences is in minor complications, except perioperative death (0.44% vs. 0.03%) and serious cardiorespiratory events (0.33% vs. 0.06%), which were higher with the percutaneous technique. Heterogeneity analysis of complication rates shows higher heterogeneity in older and surgical trials.
CONCLUSIONSPercutaneous tracheostomy is associated with a higher prevalence of perioperative complications and, especially, perioperative deaths and cardiorespiratory arrests. Postoperative complication rates are higher with surgical tracheostomy. (Crit Care Med 1999; 27:1617-1625)</description><subject>Adult</subject><subject>Age Distribution</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Cross Infection - etiology</subject><subject>Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics</subject><subject>Heart Arrest - etiology</subject><subject>Hemorrhage - etiology</subject><subject>Humans</subject><subject>Mediastinal Emphysema - etiology</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Patient Selection</subject><subject>Pneumothorax - etiology</subject><subject>Research Design</subject><subject>Severity of Illness Index</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the upper aerodigestive tract</subject><subject>Tracheoesophageal Fistula - etiology</subject><subject>Tracheostomy - adverse effects</subject><subject>Tracheostomy - methods</subject><subject>Tracheostomy - mortality</subject><subject>Tracheostomy - trends</subject><subject>Tracheotomy - adverse effects</subject><subject>Tracheotomy - methods</subject><subject>Tracheotomy - mortality</subject><subject>Tracheotomy - trends</subject><subject>Treatment Outcome</subject><issn>0090-3493</issn><issn>1530-0293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUtPwzAMgCMEYmPwF1APiFshrzYLt2niJU2CA5wjN3VZIV1H0mravyfQ8bgQKYosfXbsz4QkjF4wqtUljUdwmadMa02nMUrjlWyPjFkmYsC12CdjSjVNhdRiRI5CeKWUyUyJQzJiVCqqlByT_BG97TtYYduHpPVJ6P1LbcElnQe7xDZ0bbO9SmZJgx2ksAK3DXU4JgcVuIAnu3dCnm-un-Z36eLh9n4-W6RWCMrSjEmR5RbLAoVUDAByKJRCmnNuQbHYT14yy6HIONdKadRVDhZ4WWZaChQTcj7UXfv2vcfQmaYOFp0bGjYqjq1knHZCpgNofRuCx8qsfd2A3xpGzacz8-3M_DgzX85i6unuj75osPyTOEiKwNkOgBDNVB5Wtg6_nJZMaRUxOWCb1nXow5vrN-jNEsF1S_PfysQHMWGCbg</recordid><startdate>199908</startdate><enddate>199908</enddate><creator>Dulguerov, Pavel</creator><creator>Gysin, Claudine</creator><creator>Perneger, Thomas V</creator><creator>Chevrolet, Jean-Claude</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199908</creationdate><title>Percutaneous or surgical tracheostomy: A meta-analysis</title><author>Dulguerov, Pavel ; Gysin, Claudine ; Perneger, Thomas V ; Chevrolet, Jean-Claude</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3301-514356cedbe3471aaa6ab77e0622ca711456d1c2ab5229779e9f6aca2dd5943e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adult</topic><topic>Age Distribution</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Cross Infection - etiology</topic><topic>Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics</topic><topic>Heart Arrest - etiology</topic><topic>Hemorrhage - etiology</topic><topic>Humans</topic><topic>Mediastinal Emphysema - etiology</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Patient Selection</topic><topic>Pneumothorax - etiology</topic><topic>Research Design</topic><topic>Severity of Illness Index</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the upper aerodigestive tract</topic><topic>Tracheoesophageal Fistula - etiology</topic><topic>Tracheostomy - adverse effects</topic><topic>Tracheostomy - methods</topic><topic>Tracheostomy - mortality</topic><topic>Tracheostomy - trends</topic><topic>Tracheotomy - adverse effects</topic><topic>Tracheotomy - methods</topic><topic>Tracheotomy - mortality</topic><topic>Tracheotomy - trends</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dulguerov, Pavel</creatorcontrib><creatorcontrib>Gysin, Claudine</creatorcontrib><creatorcontrib>Perneger, Thomas V</creatorcontrib><creatorcontrib>Chevrolet, Jean-Claude</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dulguerov, Pavel</au><au>Gysin, Claudine</au><au>Perneger, Thomas V</au><au>Chevrolet, Jean-Claude</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Percutaneous or surgical tracheostomy: A meta-analysis</atitle><jtitle>Critical care medicine</jtitle><addtitle>Crit Care Med</addtitle><date>1999-08</date><risdate>1999</risdate><volume>27</volume><issue>8</issue><spage>1617</spage><epage>1625</epage><pages>1617-1625</pages><issn>0090-3493</issn><eissn>1530-0293</eissn><coden>CCMDC7</coden><abstract>OBJECTIVETo compare percutaneous with surgical tracheostomy using a meta-analysis of studies published from 1960 to 1996.
DATA SOURCESPublications obtained through a MEDLINE data-base search with a Boolean combination (tracheostomy or tracheotomy) and complications, with constraints for human studies and English language.
STUDY SELECTIONPublications addressing all peri- and postoperative complications. Studies limited to specific tracheostomy complications or containing insufficient details were excluded. Two authors independently selected the publications.
DATA EXTRACTIONA list of relevant surgical variables and complications was compiled. Complications were divided into peri- and postoperative groups and further subclassified into severe, intermediate, and minor groups. Because most studies of percutaneous tracheostomy were published after 1985, surgical tracheostomy studies were divided into two periods1960 to 1984 and 1985 to 1996. The articles were analyzed independently by three investigators, and rare discrepancies were resolved through discussion and data reexamination.
DATA SYNTHESISEarlier surgical tracheostomy studies (n = 17; patients, 4185) have the highest rates of both peri- (8.5%) and postoperative (33%) complications. Comparison of recent surgical (n = 21; patients, 3512) and percutaneous (n = 27; patients, 1817) tracheostomy trials shows that perioperative complications are more frequent with the percutaneous technique (10% vs. 3%), whereas postoperative complications occur more often with surgical tracheotomy (10% vs. 7%). The bulk of the differences is in minor complications, except perioperative death (0.44% vs. 0.03%) and serious cardiorespiratory events (0.33% vs. 0.06%), which were higher with the percutaneous technique. Heterogeneity analysis of complication rates shows higher heterogeneity in older and surgical trials.
CONCLUSIONSPercutaneous tracheostomy is associated with a higher prevalence of perioperative complications and, especially, perioperative deaths and cardiorespiratory arrests. Postoperative complication rates are higher with surgical tracheostomy. (Crit Care Med 1999; 27:1617-1625)</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>10470774</pmid><doi>10.1097/00003246-199908000-00041</doi><tpages>9</tpages></addata></record> |
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| ispartof | Critical care medicine, 1999-08, Vol.27 (8), p.1617-1625 |
| issn | 0090-3493 1530-0293 |
| language | eng |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Age Distribution Biological and medical sciences Child Cross Infection - etiology Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics Heart Arrest - etiology Hemorrhage - etiology Humans Mediastinal Emphysema - etiology Medical sciences Middle Aged Patient Selection Pneumothorax - etiology Research Design Severity of Illness Index Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the upper aerodigestive tract Tracheoesophageal Fistula - etiology Tracheostomy - adverse effects Tracheostomy - methods Tracheostomy - mortality Tracheostomy - trends Tracheotomy - adverse effects Tracheotomy - methods Tracheotomy - mortality Tracheotomy - trends Treatment Outcome |
| title | Percutaneous or surgical tracheostomy: A meta-analysis |
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