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Confirmation of No Causal Relationship Between Tracheotomy and Aspiration Status: A Direct Replication Study
Authors:Steven B Leder  Douglas A Ross
Institution:(1) Department of Surgery, Section of Otolaryngology, Yale University School of Medicine, P.O. Box 208041, New Haven, CT 06520-8041, USA;(2) Department of Surgery, St. Vincent’s Medical Center, Bridgeport, CT 06606, USA
Abstract:Debate continues regarding an association between tracheotomy and aspiration status. The aim of this research was to perform a direct replication study to investigate further the causal relationship, if any, between tracheotomy and aspiration. Twenty-five consecutive adult hospitalized patients participated. Inclusion criteria were a pretracheotomy dysphagia evaluation, subsequent tracheotomy and tracheotomy tube placement, then a post-tracheotomy dysphagia reevaluation prior to decannulation. Twenty-two (88%) participants exhibited the same aspiration status or resolved aspiration pre- versus post-tracheotomy. Three participants exhibited new aspiration post-tracheotomy due to worsening medical conditions. Conversely, four participants exhibited resolved aspiration post-tracheotomy due to improved medical conditions. Excluding these seven participants, all nine participants who aspirated pretracheotomy also aspirated post-tracheotomy and all nine participants who did not aspirate pretracheotomy also did not aspirate post-tracheotomy (P > 0.05). No statistically significant differences were found between aspiration status and days since tracheotomy (χ 2 = 0.08, P > 0.05) or between age and aspiration status (P > 0.05). The absence of a causal relationship between tracheotomy and aspiration status was confirmed.
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