Having a tracheostomy may not affect your life expectancy as much as the condition that requires getting one.

Sometimes, medical complications arise that require healthcare professionals to perform interventions to protect your life if you’re having conditions involving breathing difficulties. Doctors perform a procedure known as a tracheostomy when an individual has difficulty breathing. Breathing difficulties may be due to various reasons. The most common causes are blockages or an inability to breathe independently.

In a tracheostomy, a surgeon creates an opening in the front of your neck and into the trachea or windpipe. The surgeon then inserts the tube in the opening so air flows directly into the lungs — allowing you to breathe.

Some people may need tracheostomies temporarily, while others may need them permanently. Understanding what complications might occur because of this procedure and whether these might affect your life expectancy can give you a broader perspective.

Tracheostomy is less a determining factor of life expectancy than your underlying health and the reasons to perform the procedure. In particular, some long-term (chronic) conditions can reduce life expectancy after a tracheostomy. Likewise, age can also be a predicting factor for life expectancy.

However, even though underlying health is usually a bigger influence, long-term tracheostomies correlate more with shorter life expectancy — across all ages. Still, people most at risk from complications include babies, people who smoke, and older adults.

Temporary tracheostomies and life expectancy

A doctor may perform a temporary tracheostomy in the event of an emergency. For individuals, assuming there are no other major underlying health concerns that would influence the outcomes, tracheostomies don’t pose a major risk to overall health and life expectancy.

Permanent tracheostomies and life expectancy

In most cases, people who require permanent tracheostomies tend to have more long-term (chronic) or serious medical conditions that make breathing independently difficult or impossible. Studies show that tracheostomies are not independent predictors of your life expectancy. However, when coupled with more severe disease or injuries, there may be a higher chance of reduced life expectancy after tracheostomy.

For example, an old 2016 study with 187 tracheostomy-dependent participants who underwent hospitalization between 2009 and 2015 were categorized based on the cause of a tracheostomy. The categories were pulmonary, neurologic, or anatomic/airway obstruction. Of the entire study group, 45 participants died during the time period, with the median time to death being 9.8 months after having a tracheostomy.

Meanwhile, overall survival rates were 83% at 1 year post-tracheostomy and 68% 5 years after. However, of the mortality group, those with pulmonary issues as the cause for a tracheostomy had the shortest time to death, and children with neurological issues were less likely to have their tracheostomy removed.

Meanwhile, another 2016 study involved older adults on ventilators after a tracheostomy. This study reviewed participants admitted and later discharged from an ICU after receiving a tracheostomy and were on ventilators between 1999 and 2013.

A total of 114 participants were part of the review and post-survey. At the time of discharge, 59 were dependent on ventilators, while the remaining 55 were weaned pre-ICU discharge. The findings of the study say that while quality of life wasn’t ideal — based on survey results — survival rates in both subcategories of participants were not significantly different. The 1-year survival rate was 73% for the ventilator-dependent group and 69% for the weaned group. At 5 years, the rates were 40% and 42%, respectively.

As with the pediatric study, participants with pulmonary issues were more likely to spend longer in the ICU, especially if they were ventilator-dependent. Note that the participating adults had chronic illnesses and were referred to a tertiary hospital after getting discharged from a primary healthcare facility.

Life expectancy for COVID-19-related tracheostomies

SARS-CoV-2, a respiratory virus in more severe cases, can make breathing difficult. As a result, some people with severe COVID-19 after hospitalization required a tracheostomy and intubation to alleviate breathing problems and increase oxygen intake. This was especially true at the start of the year when vaccines and proven medications that could reduce symptoms were not readily available.

A 2021 study reviewed data from adults between April 2020 and January 2021 who required short-term intubation because of COVID-19. There were 51 participants, primarily male, with a median age of 52 years. According to the study, short-term intubation had no direct effect on life expectancy.

While the group had a general mortality rate of 66.66%, it wasn’t related to the tracheostomy but rather to COVID-19 progression and underlying health issues that worsened the virus’ impact.

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As with any surgery, tracheostomies also carry some risks. The most severe outcomes, although rare, tend to include allergic reactions to anesthesia, scar tissue formation at the incision or in the trachea, and infections such as pneumonia or tracheitis.

Other concerns can include:

  • thyroid gland damage
  • lung collapse
  • formation of connective tissue and blood vessels in the airway (granulation tissue)
  • air trapped under the skin
  • damage to the area around the stoma
  • atypical tunnels between two parts of the body (fistula formation)

One of the best ways to prevent complications after a tracheostomy is to keep the tracheostomy tube and stoma (incision site) clean and to be alert for signs of infection.

Follow all care guidelines or instructions provided by your healthcare team. Likewise, ensure changing the tracheostomy tube as per the recommended guidelines, which is usually every one to three months.

You’ll also want to avoid submerging your tracheostomy tube and stoma in water. Note that short-term tracheostomies will have stomas that usually close on their own once the surgeon removes the tubing. With long-term tracheostomies, you may require additional surgery to close the opening.

Tracheostomies are surgeries that ensure proper breathing if an individual is experiencing paralysis, an airway blockage, or other respiratory conditions when breathing independently becomes difficult.

The life expectancy is usually unaffected with temporary tracheostomies, assuming that the person having them has no chronic underlying health conditions.

With long-term or permanent tracheostomies, your underlying health conditions and being in an at-risk group (babies, people who smoke, and older adults) adversely affect life expectancy more than the procedure and apparatus.