Comparison of complications in open tracheostomy in patients taking low-dose aspirin

Objective The use of aspirin in patients undergoing open tracheostomy is an issue for which there is still no clear conclusion. This uncertainty leads surgeons to make decisions based on the risks and benefits of continuing versus discontinuing aspirin. Therefore, this study aims to investigate complications related to aspirin use. The primary outcome was bleeding complications, while other complications were secondary outcomes. Methods This was a retrospective study compiling data from patients who underwent open tracheostomy at the Department of Otolaryngology, Faculty of Medicine, Chulalongkorn university and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, between January 2019 and December 2023. Demographic data, medical conditions, indications for tracheostomy, surgeon characteristics, operative time, aspirin use status, and complications were reviewed. Results There were 47 patients in total in this study: 15 patients in the aspirin continuation group and 32 patients in the aspirin discontinuation group. In the aspirin continuation group, there were no major or minor bleeding events. In the discontinuation group, there were two cases of major bleeding and two cases of minor bleeding (an incidence of 6.3% for each), although the differences observed were not statistically significant. There were no other complications that showed statistically significant differences between the two groups. Conclusion This study has shown that low-dose aspirin (81 mg) does not increase the risk of bleeding or other complications in patients who undergo open tracheostomy. These results support that the continuation of aspirin may be safe in patients undergoing this procedure.