Reasons for Trachs

Reasons for a Trach & Stats:

(The following are NOT claims that the Wright Mask has done clinical trials for these problems- the following are REASONS FOR TRACHS.)

Airway Problems:
Airway burns from inhalation of corrosive material, poisons, smoke or steam
Congenital Abnormalities of the airway
Benign Tracheal Tumor
Foreign body obstruction
Hemangioma Tumor & Subglottic Hemangioma
Infection, such as Epiglottitis
Large tongue or small jaw that blocks airway
Laryngectomy
Laryngeal injury or spasms
Laryngomalacia - Bilateral Vocal Paralysis
Morbid Obesity
Severe neck or mouth injuries
Severe Sleep Apnea
Subglottic Stenosis
Tracheal Malasia
Tracheomalacia
Tracheoessphageal fisula
Treacher Collins and Pierre Robin Syndromes
Tumors, such as Cystic Hygroma
Tumors and/or Head and Neck Cancer (SCCH&N) complication, involvement
Obstructive sleep apneaVocal Cord Paralysis (VCP) Pompe

Lung Problems:
Chest wall injury
Chronic pulmonary disease to reduce anatomic dead space
Chronic pulmonary Disease - bronchitis, emphysema, asthma
Diaphragm dysfunction
Need for prolonged respiratory support, such as Bronchopulmonary Dysplasia (BPD)

Other Reasons:
Aspiration related to muscle or sensory problems in the throat
Anaphylaxis (severe allergic reaction, restricted airway due to venomous snake, scorpion, bee, wasp, hornet bite/sting)
Avian Influenza
Cerebral Palsy
Congential Diaphagmatic Hernia
Disorders of respiratory control such as Congenital Central Hypoventilation or Central Apnea
Facial surgery and facial burns
Fracture of cervical vertebrae with spinal cord injury
Hanta Virus
Long-term unconsciousness or coma
Neuromuscular diseases paralyzing or weakening chest muscles and diaphragm
Pyrexial Conditions (croup, diptheria)
Sars
Spina Bifida
Systic Mygroma
Tetralogy of Fallot with Absent Pulmonary Valve
Thoracic Cage Abnormalities
x-linked myotublar myopathy
Venomous Snake Bites

TRACHEOSTOMY STATS

With tracheotomy statistics difficult to confirm, it appears there may be as many as 6.5 million people living with tracheostomies in the U.S. (2.21% of 294,043,000 population 2003) Please see Table 4 below.

Experts believe this number will increase significantly as 88.5 million baby boomers will reach 65 years of age by 2050. Some estimates indicate as many as half - 44 million patients will face respiratory problems, resulting in many needing tracheotomies.

General Tracheostomy Stats (2004 AHRQ)

· Tracheotomies are the 2nd most costly hospital stays = $240,000 (mean cost) In both 1997 and 2003, hospital charges were highest for stays involving organ transplantations of the pancreas, liver, intestine, heart, and lung. The mean charge associated with a hospital stay that included these five transplants was $275,600 (a 17-percent increase from 1997, after adjusting for inflation). Hospital stays in which a tracheostomy was performed were nearly as expensive, with a mean charge of $240,000 (a 23-percent increase from 1997, after adjusting for inflation). http://www.hcup-us.ahrq.gov/reports.jsp

· 1 in 25 patients received respiratory intubation or mechanical ventilation which is the 3rd most common procedure

· Tracheostomy longevity 'Short-term' up to 18 months for Accidents/ Injuries/ diseases/ end of Disease-life

· Tracheostomy longevity 'Long-term' = 2-30 years for Quadriplegic patients; Airway management / Airway specific diseases

Trach Stats Are Difficult To Find...

Information is power, it's hope, it brings levity and it brings Quality of Life!

So what? Who cares about Trach Stats?

We care!

As the person with a hole in his neck Dean cared! As his loved one and caregiver, cleaning and suctioning that hole, I cared!

We wanted to know we weren’t alone. We wanted to know that in this new millennium medical expertise and support was in place.

Of course we wanted to know the science, about the loss of voice/voice distortion, the difficulty swallowing, the mucus, secretions, the coughing, cleaning, infections, etc.

We also wanted to know about the personal side of this new community we found ourselves in! Who has to have trachs. How old are they, how long do they live with this additional orifice? What insights can they share with us?

Unfortunately there's no one place that compiles complete trach stats. We know our mask will make a difference in your life. It will improve the quality of your life and by answering our 'Survey Page', together we will gather our own trach stats.

Trached

Little did we know that once Dean’s tracheostomy was in place he would become an ambassador for Tracheostomies!

Ambassador

From seniors to children everyone had questions about it but were embarrassed to ask.

Dean boasted that a Tracheotomy procedure is one of the most expensive Medical procedures one can have – after organ transplants.

He got a chuckle out of suggesting that people not stand directly in front of him because if he coughed and didn’t have time to cover his trach he could spew mucus 6’ straight out!

Dean even went so far as to suggest our friends’ children brush up on their math by working out how fast the mucus travels - how much velocity is behind a cough. He also showed them how we cleaned, nebulized and suctioned his trach.

We care! (please read the following disclaimer)

The Federal AHRQ (Agency for Healthcare Research & Quality) along with (41) state(s) and a few industry partners have compiled (as of May 19th 2009)a database called HCUP (Healthcare Cost & Utilization Project). The partners report some patient hospital stays, the number of some procedures performed, the cost of those procedures etc.

Unfortunately, NOT every state and only FEW, ‘Industry’ entities take part in this sharing of information with HCUP. Needless to say, tracheotomy procedures and related stats are inconclusive. These stats are weighted, however, even weighted, the hard numbers do not include

all hospitals (Regional, National Systems)

all rehab facilities

all long term care facilities

all acute care facilities

all VA facilities

all specialty hospitals (Childrens', Burns)

HCUP’s State	& Industry Partners that share Medical Stats	NOT sharing stats w/ HCUP
Arizona	Dept of Health Services	Alabama
Arkansas	Dept of Health & Human Services	Alaska
California	Office of Statewide Health Planning & Devlmnt	Delaware
Colorado	Health & Hospital Association	District of Columbia
Connecticut	Integrated Health Information (Chime, Inc.)	Idaho
Florida	Agency for Health Care Administration	Louisiana
Georgia	An Assoc. of Hospitals & Heath Systems (GHA)	Mississippi
Hawaii	Health Information Corporation	Montana
Illinois	Health Care Cost Containment Council	New Mexico
Indiana	Hospital & Health Association	North Dakota
Iowa	Hospital Association
Kansas	Hospital Association
Kentucky	Department of Public Health
Maine	Maine Health Data Organization
Maryland	Health Services Cost Review Commission
Massachusetts	Division of Health Care Finance & Policy
Michigan	Health & Hospital Association
Minnesota	Hospital Association
Missouri	Hospital Industry Data Institute
Nebraska	Hospital Association
Nevada	Division of Health Care Fiancing & Policy, Dept of HR
New Hampshire	Dept of Health & Human Services
New Jersey	Department of Health & Senior Services
New York	State Department of Health
North Carolina	Department of Health & Human Services
Ohio	Hospital Association
Oklahoma	Oklahoma Hospital Association
Oregon	Association of Hospitals & Health Systems
Pennsylvania	Pennsylvania Health Care Cost Containment Council
Rhode Island	Department of Health
South Carolina	State Budget and Control Board
South Dakota	Association of Healthcare Organizations
Tennessee	Hospital Association
Texas	Health Care Information Council
Utah	Department of Health
Vermont	Association of Hospitals & Health Systems
Virginia	Health Information
Washington	State Department of Health
West Virginia	Health Care Authority
Wisconsin	Department of Health and Family Services
Wyoming	Wyoming Hospital Association

2006 National statistics - the number of discharges in all hospitals who received the procedure whether it was a principal or secondary procedure:

Most common procedures rank # (ccs code #)		Total number of discharges	Standard error of total number of discharges
98 (34)	Tracheostomy (surgical placement of a hole in the trachea - passage to lung - to assist breathing	118,104	4,353

Weighted national estimates from HCUP Nationwide Inpatient Sample (NIS), 2006, Agency for Healthcare Research and Quality (AHRQ), based on data collected by individual States and provided to AHRQ by the States. Total number of weighted discharges in the U.S. based on HCUP NIS = 39,450,216. Statistics based on estimates with a relative standard error (standard error / weighted estimate) greater than 0.30 or with standard error = 0 in the nationwide statistics (NIS and KID) are not reliable. These statistics are suppressed and are designated with an asterisk (*). The estimates of standard errors in HCUPnet were calculated using SUDAAN software. These estimates may differ slightly if other software packages are used to calculate variances.

2006 National statistics - principal procedure only

Outcomes for	multiple	specific	procedures	Standard	Errors
CCS principal procedure category and name	Total number of discharges	Charges, $ (mean)	In-hospital deaths	Total number of discharges	Charges, $ (mean)	In-hospital deaths
34 -Tracheostomy, temporary and permanent	68,600	219,217	12,673 (18.47%)	2,406	7,357	589 (0.59%)

2006 National statistics - principal procedure only-

Patient and hospital characteristics for CCS principal procedure category Tracheostomy (surgical placement of a hole in the trachea - passage to lung - to assist breathing

		Standard Errors
	Total number of discharges	Total number of discharges
All discharges	68,600 (100%)	2,406
Age group <1	1,040 (1.52%)	169
1-17	1,534 (2.24%)	204
18-44	10,242 (14.93%)	643
45-64	25,502 (37.18%)	993
65-84	26,533 (38.68%)	972
85+	3,715 (5.42%)	255
Missing	*

2006 National statistics - principal procedure only - Patient and hospital characteristics for CCS principal procedure category Tracheostomy (surgical placement of a hole in the trachea - passage to lung - to assist breathing

		Standard Errors
	Total number of discharges	Total number of discharges
All discharges	68,600 (100%)	2,406
Region -
Northeast	17,060 (24.87%)	1,369
Midewest	12,467 (18.17%)	838
South	26,412 (38.50%)	1,496
West	12,661 (18.46%)	988

AHRQ http://hcupnet.ahrq.gov/HCUPnet

Internationally most countries do not consider tracheotomy procedures statistically noteworthy as it is considered a secondary procedure carried out because of a primary issue. The following countries do consider the statistics below noteworthy. Table 5. * denotes estimates only

Country	Population 2008*	Trached Population*	%*
Australia	21,581,772	4,983,231	23.09
Canada	33,143,600	3,367,390	10.16
Scotland	5,144,200	836,961	16.27
UK	60,975,000	5,109,705	8.38
USA	305,748,470	6,757,041	2.21