Late complications of tracheostomy in adult patients in a chronic care facility: a retrospective observational study

Introduction: Prolonged tracheostomy is associated with chronic complications that compromise respiratory, phonatory, and swallowing functions, particularly in institutionalized patients with multiple comorbidities. Evidence in long-term care settings remains limited, highlighting the need for local data. Methods: We conducted an observational, retrospective, cross-sectional study in a chronic care facility in Buenos Aires during 2024. A total of 87 adult patients with tracheostomy ≥3 months were included. Clinical, functional, and structural variables were collected and analyzed using descriptive statistics, correlation tests, and logistic regression. Results: All patients presented phonatory and/or swallowing dysfunction, and 64.3% developed multiple complications. The most frequent were granulation tissue formation (21.8%), recurrent respiratory infections (20.7%), and tracheal stenosis/ tracheomalacia (18.4%). Cannulation time was an independent predictor of multiple complications (OR = 1.18; p<0.01), as was prolonged invasive mechanical ventilation (p<0.05). Functional impairment was severe: 44.8% of patients had total and 24.1% severe dependency according to the Barthel Index. Conclusion: Late complications are highly prevalent in chronically tracheostomized patients and are associated with significant functional deterioration. These findings underscore the importance of structured follow-up protocols, periodic endoscopic evaluations, and interdisciplinary rehabilitation, as well as the need for multicenter prospective studies to support the development of national clinical guidelines.