Living span with tracheostomy: Duration involved

Life span with a tracheostomy: duration details

A tracheostomy is a medical procedure that creates an opening in a person's trachea to help them breathe. This life-saving intervention is often necessary for individuals with upper airway obstruction or severe conditions such as pneumonia or stroke. However, it's crucial to understand the long-term implications of a tracheostomy.

For those living with a tracheostomy, maintaining the site and tube cleanliness is essential, and they may need to suction mucus and clean the tube several times a day. Short-term risks include surgical risks of bleeding and infection, neck injury, and accidental decannulation.

However, it's the long-term risks that significantly impact the longevity and quality of life of tracheostomy patients. Studies show that tracheostomy-dependent individuals, particularly children with chronic conditions like bronchopulmonary dysplasia (BPD), face significant complications such as tracheitis, stomal granuloma, airway stenosis, and accidental decannulation. These complications contribute to increased morbidity and mortality, with reported mortality rates around 30% in some pediatric cohorts.

High rates of hospital readmissions are typical, reflecting ongoing respiratory and airway challenges. Among children, nearly one-third are readmitted within 30 days, and over half within 2 years. Such frequent healthcare interventions impact overall wellbeing and stability.

Many survivors require prolonged tracheostomy dependence with multiple additional airway surgeries, although many pediatric patients can be decannulated eventually. Long-term tracheostomy patients often face lifestyle adjustments, including dependence on durable tracheostomy tubes and respiratory equipment, limitations on physical activities, and the need for specialized care management at home. Quality of life can be affected by physical discomfort, communication difficulties, and social isolation.

Prolonged mechanical ventilation and tracheostomy can lead to psychological distress and depression. Studies on ventilated patients noted psychological issues related to prolonged support. Depression is common due to chronic health problems, altered body image, communication barriers, and lifestyle restrictions, although quantitative data specifically linking tracheostomy and depression prevalence is limited.

Research suggests that people with a tracheostomy may have a higher risk of death in the hospital compared to those without one. The risk of death may increase by 0.7% with each year of age and by 0.8% with each additional day in the hospital.

Conversely, adults with indications for tracheostomy but managed with early versus late placement show little difference in overall mortality but variable outcomes in ICU duration and some measures of respiratory complications, suggesting timing also plays a role in long-term results.

In summary, compared to individuals without tracheostomy, those with a tracheostomy typically face reduced longevity, high hospital readmissions, frequent complications, decreased quality of life, increased psychological impact, and a higher risk of death, particularly in the hospital setting.

It's essential for anyone considering a tracheostomy to discuss the benefits and possible risks with their doctor. Their doctor can answer questions, advise on assistance and support they can access when they have a tracheostomy, and help them navigate the challenges that come with this life-saving intervention.

References: [1] High Rates of Readmission and Airway Complications Found in Tracheostomy-Dependent Infants with BPD, Nationwide Children’s, 2025. [2] Durable Tracheostomy Tubes and Quality of Life, Regional Medical Sources, 2025. [3] Early vs Late Tracheostomy in Adults with Multiple Injuries: Mortality and Outcomes, Cochrane Review, 2025. [4] Psychological and Physical Impact of Mechanical Ventilation and Tracheostomy, Apex Hospitals, 2025. [5] Tracheostomy and Depression Risk: A 2019 Study, Global Mental Health Journal, 2019.