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Tracheostomy before and during COVID-19 pandemic Cover

Tracheostomy before and during COVID-19 pandemic

Open Access
|Jun 2024

Figures & Tables

The main causes of upper airway obstruction

Causes of upper airway obstructionNo. of patientsRatio (%)
All patients82100
Laryngeal cancer2429
Pharyngeal cancer2024
Cancer of other primary sites79
Infections1620
Bilateral vocal cord paralysis1316
Laryngo-tracheal stenosis22

A comparison of the risk factors in all patients before and during the COVID-19 outbreak in Slovenia

Risk factorOverallBefore the outbreak of COVID-19During the pandemic of COVID-19p value
All patients824141
Patients
  Age (years) mean, range66.8 (28–97)64.8 (28–91)68.8 (42–97)0.172a
  Male sex62 (76%)31 (76%)31 (76%)1.00c
  Body weight (kg) mean, range73.5 (35–143)71.9 (35–143)75.2 (43–110)0.512 a
  Body height (cm) mean, range172 (150–185)172 (150–185)173 (152–183)0.933a
  Body mass index (kg/m2), mean, range25.4 (12.7–37.6)24.2 (12.7–37.6)27.6 (19,4–35,5)0.178a
The upper airway obstruction
Respiratory distress duration (days), median, range6 (1–180)10.5 (1–90)3 (1–180)0.373b
Causes of acute airway obstruction 0.826c
  Laryngeal cancer24 (29%)12 (29%)12 (29%)
  Pharyngeal cancer20 (24%)8 (20%)12 (29%)
  Other cancers7 (9%)5 (12%)2 (5%)
  Inflammation16 (20%)8 (20%)8 (20%)
  Vocal cord paralysis13 (16%)7 (17%)6 (15%)
  Laryngotracheal stenosis2 (2%)1 (2%)1 (2%)
  Multiple causes22 (27%)11 (27%)11 (27%)1.000c
  Respiration space (mm) mean, range2.3 (1–5)2.5 (1–4)2.2 (1–5)0.635a
Symptoms
  Dysphagia26 (32%)12 (29%)14 (34%)0.635c
  Trismus6 (7%)5 (12%)1 (2%)0.101d
  Pain19 (23%)8 (20%)11 (27%)0.432c
Stridor 0.504c
  Inspiratory31 (38%)17 (42%)14 (34%)
  Biphasic1 (1%)01 (2%)
Previous treatment
  Surgery14 (17%)5 (12%)9 (22%)0.379d
  RT11 (13%)5 (12%)6 (15%)1.000d
  CRT11 (13%)5 (12%)6 (15%)1.000d
Surgery
  Re-TS4 (5%)04 (10%)0.116d
  Cricothyrotomy6 (7%)3 (7%)3 (7%)1.000d
  Surgeon specialist68 (83%)34 (83%)34 (83%)1.000c
  Time-dependent aspect of TS 0.806c
  Emergent59 (72%)29 (71%)30 (73%)
  Urgent23 (28%)12 (29%)11 (27%)
  Duration (hour) median, range0.75 (0.25–2.50)0.75 (0.25–2.5)0.88 (0.25–2)0.546b
Anaesthesia 1.000d
  Local5 (6%)2 (5%)3 (7%)
  General77 (94%)39 (95%)38 (93%)
  Duration (hour) median, range1.50 (0.75–3.25)1.5 (0.75–3.25)1.75 (1–3,25)0.198b
ASA classification 0.952c
  II6 (7%)3 (7%)3 (7%)
  III44 (53%)23 (56%)21 (51%)
  IV16 (20%)9 (22%)7 (17%)
  Unknown10 (20%)6 (15%)10 (25%)
Mallampati classification 0.810 c
  I7 (9%)5 (12%)2 (5%)
  II10 (12%)6 (15%)4 (10%)
  III13 (16%)7 (17%)6 (14%)
  IV14 (17%)7 (17%)7 (17%)
  Unknown38 (46%)16 (39%)22 (54%)
Mouth opening 0.207d
  Inadequate7 (9%)6 (15%)1 (2%)
  Adequate34 (41%)18 (44%)16 (39%)
  Unknown41 (50%)17 (41%)24 (59%)
Hyo/thyromental distance 1.000c
  Insufficient5 (6%)3 (7%)2 (5%)
  Sufficient35 (43%)21 (51%)14 (34%)
  Unknown42 (51%)17 (42%)25 (61%)
Endotracheal tube type 0.072c
  Wire32 (39%)18 (44%)14 (34%)
  Straight4 (5%)4 (10%)0
  Curved7 (8%)2 (5%)5 (12%)
  Unknown39 (48%)17 (41%)22 (54%)
Orotracheal intubation 0.043d*
  C-MAC laringoscope7 (9%)1 (3%)6 (15%)
  Laryngoscope60 (73%)35 (85%)25 (61%)
  Unknown15 (18%)5 (12%)10 (24%)

A comparison of the risk factors in patients with HNC before and during the COVID-19 outbreak in Slovenia

Risk FactorOverallBefore the Outbreak of COVID-19During the Pandemic of COVID-19p value
All Patients512526
Patients
  Age (years) mean, range66.2 (28–88)64.6 (28–88)67.8 (42–87)0.374 a
  Male sex44 (86%)22 (88%)22 (85%)1.000d
Primary site 0.365 c
  Laryngeal cancer24 (47%)12 (48%)12 (46%)
  Pharyngeal cancer20 (39%)8 (32%)12 (46%)
  Other cancers7 (14%)5 (20%)2 (8%)
Invasion of subsites
  Glottis21 (42%)13 (52%)8 (31%)0.124c
  Supraglottis32 (63%)16 (64%)16 (62%)0.856c
  Subglottis11 (22%)6 (24%)5 (19%)0.743d
  Trachea2 (4%)1 (4%)1 (4%)1.000d
  Hypopharynx13 (26%)3 (12%)10 (39%)0.052d
  Oropharynx16 (31%)10 (40%)6 (23%)0.193c
  Oral cavity8 (16%)4 (16%)4 (15%)1.000d
  Respiration Space (mm), mean, range2.4 ± 1.5 (1–5)3 ± 1.7 (1–4)2.2 ± 1.5 (1–5)0.714 b
Previous treatment
  Surgery8 (16%)3 (12%)5 (19%)0.703d
  RT10 (20%)4 (16%)6 (23%)0.726d
  CRT8 (16%)4 (16%)4 (15%)1.000d
Surgery
  Time-dependent aspect of TS 0.806 c
  Emergent34 (67%)16 (64%)18 (69%)
  Urgent17 (33%)9 (36%)8 (31%)
  Orotracheal intubation 0.047d*
  C-MAC7 (14%)1 (4%)6 (23%)
  Laryngoscope38 (74%)22 (88%)16 (62%)
  Unknown6 (12%)2 (8%)4 (15%)
DOI: https://doi.org/10.2478/raon-2024-0034 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Page range: 556 - 564
Submitted on: Apr 4, 2024
Accepted on: May 16, 2024
Published on: Jun 12, 2024
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2024 Sara Jensterle, Janez Benedik, Robert Sifrer, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.