Revision to Tracheostomy Postcricothyroidotomy is Associated with Increased Rates of Laryngotracheal Stenosis

Journal of Emergencies, Trauma and Shock · Published 2025-10-01 · DOI 10.4103/jets.jets_2_25

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Abstract

Introduction: Cricothyroidotomy establishes an emergency surgical airway, but concerns persist that cricothyroidotomy only (CO) may be associated with higher rates of tracheal stenosis than revision to tracheostomy (RT). We characterized the incidence of RT and rates of tracheal stenosis. Methods: We identified patients aged 19–90 years of age undergoing cricothyroidotomy in the TriNetX database from January 1, 2011 to December 31, 2020. We divided patients into CO or RT groups. The primary outcome of interest was 1-year cumulative incidence of tracheal stenosis. Results: Six hundred and sixty-eight patients underwent cricothyroidotomy (mean age 50 standard deviation 19 years, 76% male, 34% with cardiac arrest, and 29% head injury) of whom 355 (53.1%) underwent RT. Accounting for 1-year mortality (56.7% CO vs. 34.5% RT, P < 0.001), the 1-year cumulative incidence of tracheal stenosis was higher in the RT group (13.0% vs. 4.9%, P < 0.001). Conclusion: Cumulative incidence of 1-year mortality is high in patients undergoing cricothyroidotomy, while RT is associated with increased risk of tracheal stenosis.

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Year
2025

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