Tracheotomy: Changing Indications and a Review of 1130 Cases
Bibliographic record
Abstract
BACKGROUND: Tracheotomy is one of the oldest known operations, dating back to ancient Egypt and India some 3000 years ago. The indications for tracheotomy have changed and expanded during the twentieth century. Today, owing to advancements in intensive care and the widespread use of mechanical ventilation, tracheotomy is one of the most commonly performed surgical procedures and is encountered on a regular basis by hospital physicians in all fields. We present one of the largest series of consecutive tracheotomies spanning one decade. We review and discuss the modern indications for tracheotomy and emphasize the changes in these indications over the past century. METHODS: A retrospective study of 1,130 consecutive tracheotomies performed over one decade is presented. We studied the indications for surgery, the complications and mortality rate, and the various hospital departments requiring tracheotomies. RESULTS: A total of 1,130 tracheotomies were performed: 859 to assist in mechanical ventilation, 124 as an adjunct to head and neck or chest surgery, and 68 to relieve upper airway obstruction. Major complications occurred in 49 of the cases, and there were 8 deaths directly attributed to the tracheotomies. The most common complication was tracheal stenosis, occurring in 21 cases. Hemorrhage was the second most common complication, occurring in 9 cases. CONCLUSION: Tracheotomy, once used almost exclusively to bypass upper airway obstruction, is now a very common elective therapeutic procedure used mostly to facilitate prolonged intubation and ventilation of the critically ill. Today tracheotomy is not and should not be an emergency procedure owing to the huge complication and mortality rate of emergency tracheotomy and the existence of alternative routes to obtain immediate airway control in the acutely obstructed upper airway.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.010 | 0.009 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".