{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T02:55:31Z","timestamp":1788576931465,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T00:00:00Z","timestamp":1681344000000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["OTO Open"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Tracheostomies are performed in trauma patients for multiple purposes. Approaches to the procedure are usually directed by individual expertise and local preferences. Though generally safe, a tracheostomy can cause serious complications. This study aims to identify complications associated with tracheostomies performed at the level I Trauma Center of the Puerto Rico Medical Center (PRMC) to have an advanced foundation to develop and implement guidelines to improve patient outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A retrospective cross\u2010sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Level I Trauma Center of the PRMC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Medical charts of 113 trauma adult patients that underwent tracheostomy at the PRMC from 2018 to 2020 were reviewed. Data collected included patient demographics, surgical approach, initial tracheostomy tube size (ITTS), intubation period, and flexible laryngoscopic findings. Complications occurring during and after tracheostomy were documented. The unadjusted relationship of the independent variables and outcome measures was assessed using <jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0and Fisher's test for categorical variables and the Wilcoxon\u2010Mann\u2010Whitney rank\u2010sum test for continuous ones.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Abnormal airway findings detected on flexible laryngoscopic examination were reported in 30 patients in the open tracheostomy (OT) group and 43 patients in the percutaneous tracheostomy group (<jats:italic>p<\/jats:italic>\u2009=\u20090.007). Peristomal granulation tissue was reported in 10 patients with an ITTS 8, while in only 1 patient with an ITTS 6 (<jats:italic>p<\/jats:italic>\u2009=\u20090.026).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study showed several key findings in our cohort. The OT surgical approach was associated with fewer long\u2010term complications when compared to the percutaneous approach. Also, a statistically significant difference in peristomal granulation tissue findings was found between the ITTS,\u00a0ITTS\u20106 and ITTS\u20108, the smaller size being associated with fewer abnormal findings.<\/jats:p><\/jats:sec>","DOI":"10.1002\/oto2.48","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T04:59:57Z","timestamp":1681361997000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Tracheostomy Outcomes on Trauma Patients"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0545-4314","authenticated-orcid":false,"given":"Edgar","family":"Del Toro\u2010Diez","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, School of Medicine University of Puerto Rico San Juan Puerto Rico USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1389-0909","authenticated-orcid":false,"given":"Camila S.","family":"R\u00edos De Choudens","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, School of Medicine University of Puerto Rico San Juan Puerto Rico USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4992-9198","authenticated-orcid":false,"given":"Shayanne A.","family":"Lajud","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, School of Medicine University of Puerto Rico San Juan Puerto Rico USA"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9053-8709","authenticated-orcid":false,"given":"Jeamarie","family":"Pascual\u2010Marrero","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, School of Medicine University of Puerto Rico San Juan Puerto Rico USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Baez\u2010Bermejo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, School of Medicine University of Puerto Rico San Juan Puerto Rico USA"},{"name":"Department of Pharmacology, School of Medicine University of Puerto Rico  San Juan Puerto Rico USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.02971"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2007.05.018"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.4065\/80.12.1632"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc8218"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27500"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21907"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2005.04.025"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40271-017-0277-1"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2016.1829"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2017.11.037"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815599525"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26019"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-19-3716"},{"issue":"1","key":"e_1_2_9_15_1","first-page":"113","article-title":"Surgical tracheostomy versus percutaneous dilatational tracheostomy. A prospective\u2010randomized study with long\u2010term follow\u2010up","volume":"43","author":"Melloni G","year":"2002","journal-title":"J Cardiovasc Surg"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200008000-00014"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24943"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818794456"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.04.064"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.04.054"}],"container-title":["OTO Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/oto2.48","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T11:57:36Z","timestamp":1760961456000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/oto2.48"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1002\/oto2.48"],"URL":"https:\/\/doi.org\/10.1002\/oto2.48","archive":["Portico"],"relation":{},"ISSN":["2473-974X","2473-974X"],"issn-type":[{"value":"2473-974X","type":"print"},{"value":"2473-974X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4]]},"assertion":[{"value":"2023-01-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e48"}}