The incidence of tracheoarterial fistula in patients with chronic tracheostomy tubes: a retrospective study of 544 patients in a long-term care facility.

Abstract

OBJECTIVE: The incidence of tracheoarterial fistula (TAF) in patients with short-term tracheostomy tubes has been reported between 0.6% and 0.7%. The purpose of this study was to determine the incidence of TAF in patients with long-term tracheostomy tubes used for the management of chronic respiratory failure. SETTING: Long-term ventilator facility. DESIGN: Retrospective. METHODS: Medical records of 544 patients admitted to our institution between January 1981 and December 2002 were reviewed. All patients underwent tracheostomy prior to admission to our facility. Patient age, length of stay (LOS), duration of tracheostomy, and serum albumin levels were compared between patients with and without TAF; p values were obtained using the Student unpaired t test for equal variances. RESULTS: TAF was diagnosed in five patients. The incidence of TAF in our population was 0.7%. The average age of these patients was significantly less than the study population (31.20 years vs 68.27 years). When one patient outlier was eliminated, LOS was not significant. CONCLUSION: TAF is an uncommon complication of tracheostomy tubes. The incidence of TAF in patients with long-term tracheostomy tubes is similar to that reported in short-term tracheostomy tubes.