Percutaneous vs surgical tracheostomy: an incidence rate of stoma infection in the neurosurgery ICU of the single tertiary level hospital

Introduction: One third of all patients undergo open standard tracheostomy (ST) or bedside percutaneous dilatational tracheostomy (PDT) in our 18 bed neurosurgery ICU (NICU). The aim of our study was to evaluate the incidence rate of stoma infection after tracheostomy according to the type of procedure (PDT vs ST) in NICU patients. Methods: We performed a retrospective chart review of 240 patients who underwent tracheostomy during their stay in the NICU at our 2200 bed university teaching hospital Kaunas Clinics from October 2012 to December 2015. The data from 202 patients (140 males) with median age 58.4 (18–80) who met the inclusion criteria were used for further analysis. There were 84 patients in PDT group and 118 patients in ST group. Results: There was no significant difference between two groups in terms of age, sex, timing of tracheostomy, duration of ICU stay, mortality and infectious status before the procedure. The incidence rate of stoma infection was significantly lower in PDT group vs ST group (16.7% vs 65.3%, p < 0.001). We performed the logistic regression adjusting for age, sex, the cause of hospitalization, tracheostomy strategy and timing of the procedure. The use of ST was associated with an increase in the risk of stoma infection (OR = 8.83 95% 4.40–17.71). Conclusions: The incidence rate of stoma infection was significantly higher in ST group compared to PDT group in NICU patients