Investigation of the Causal Relationship Between Tracheotomy and Aspiration in the Acute Care Setting

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Abstract
Objective To investigate the causal relationship, if any, between tracheotomy and incidence of aspiration in the acute care setting.Study Design Prospective, consecutive.Patients and Methods Twenty adult patients evaluated between February 1997 and October 1999 participated. Criteria for inclusion were a dysphagia evaluation before tracheotomy, subsequent tracheotomy and placement of a tracheotomy tube, and then a repeat dysphagia evaluation after tracheotomy prior to decannulation. This permitted the causal relationship between tracheotomy and incidence of aspiration to be investigated. Differences between duration of tracheotomy placement and age were analyzed with the Student t test and for nonparametric nominal data the ξ2 test was applied.Results No causal relationship between tracheotomy and aspiration was exhibited, as 19 of 20 (95%) subjects exhibited the same aspiration status before and after tracheotomy. All 12 (100%) subjects who aspirated before tracheotomy also aspirated after tracheotomy and 7 of 8 (88%) subjects who did not aspirate before tracheotomy also did not aspirate after tracheotomy (P > .05). In addition, no significant differences were observed between aspiration status and days since tracheotomy or age (P > .05).Conclusion In the acute care setting, no causal relationship between tracheotomy and aspiration status was exhibited.

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