Study Finds No Long-Term Outcome Difference in Post-Intubation Stenosis

A retrospective cohort study published in BMC Pulmonary Medicine indicates that the underlying cause of post-intubation tracheal stenosis does not significantly influence long-term clinical outcomes. The research compared patients who developed the condition following intubation for COVID-19 with those who developed it for other reasons, finding that success rates for both bronchoscopic and surgical treatments remained comparable across both groups over a three-year period. This finding suggests that clinical management strategies can be tailored to individual anatomical and clinical factors rather than being dictated solely by the etiology of the initial respiratory failure.

Post-intubation tracheal stenosis is a clinically challenging condition that requires multidisciplinary management involving both bronchoscopic and surgical interventions. The incidence of this complication has increased markedly in recent years, particularly following the rise in patients requiring prolonged invasive mechanical ventilation during the pandemic period. Despite this increase, whether the specific etiology of the intubation influences the characteristics of the stenosis, the appropriate treatment strategies, and the ultimate long-term outcomes remained insufficiently understood prior to this investigation.

The study was conducted at a single center and included 111 patients who developed post-intubation tracheal stenosis following invasive mechanical ventilation between March 2020 and November 2021. All participants were followed for a minimum of three years to assess long-term clinical stability and treatment efficacy. The cohort was categorized by etiology into two distinct groups: 54 patients with COVID-19-related stenosis and 57 patients with non-COVID-19-related stenosis. This design allowed for a direct comparison of demographic characteristics, stenosis features, treatment modalities, and clinical outcomes between the two etiologies.

Baseline characteristics were largely similar between the two groups, with one notable exception regarding comorbidities. The non-COVID group exhibited a higher prevalence of multiple comorbidities compared to the COVID-19 group, with 57.9% of patients in the non-COVID group having multiple comorbidities versus 37.0% in the COVID-19 group. This difference was statistically significant, with a p-value of 0.028. Conversely, the duration of intubation was significantly longer in the post-COVID group, averaging 21 days compared to 15 days in the non-COVID group, a difference that was also statistically significant with a p-value of 0.005.

Despite these baseline differences in comorbidity burden and intubation duration, the physical characteristics of the stenosis did not differ significantly between the groups. Specifically, the type, grade, length, and location of the tracheal stenosis were comparable across both cohorts. Furthermore, the treatment modalities employed, including the choice between bronchoscopic and surgical interventions, did not show significant differences between the COVID-19 and non-COVID-19 groups.

At the three-year follow-up mark, the primary clinical outcomes were comparable between the two groups. The bronchoscopic success rate was 58.6% in the COVID-19 group and 62.2% in the non-COVID group. Surgical success rates were 73.3% for the COVID-19 group and 81.8% for the non-COVID group. Additionally, tracheostomy dependence was observed in 9.2% of the COVID-19 group and 5.3% of the non-COVID group, while mortality rates were 14.8% and 17.5% respectively. All these outcomes were statistically comparable, with p-values greater than 0.05, indicating no significant difference in long-term prognosis based on etiology.

The authors conclude that the etiology of post-intubation tracheal stenosis may not significantly influence long-term clinical outcomes. These findings support an individualized approach to treatment that is based on specific anatomical and clinical factors rather than the initial cause of the intubation. However, the study acknowledges its limitations, including its retrospective design and single-center setting. The authors emphasize that larger prospective multicenter studies are needed to confirm these results and to further validate the approach of treating patients based on individual characteristics rather than etiological categories.

By demonstrating that long-term outcomes are similar regardless of whether the stenosis is related to COVID-19 or other causes, the study provides evidence for clinicians to focus on patient-specific factors in treatment planning.

Subject of Research: Long-term clinical outcomes of post-intubation tracheal stenosis in COVID-19 versus non-COVID-19 patients

Article Title: Long-term outcomes of COVID-19-related versus non-COVID-19-related post-intubation tracheal stenosis: a retrospective cohort study

Article References: Turan, D., Chousein, E. G. U., İlhan, U., Çörtük, M., Baydili, K. N., Özgül, M. A., & Çetinkaya, E. (2026). Long-term outcomes of COVID-19-related versus non-COVID-19-related post-intubation tracheal stenosis: a retrospective cohort study. BMC Pulmonary Medicine. https://doi.org/10.1186/s12890-026-04993-7

Image Credits: AI Generated

DOI: 10.1186/s12890-026-04993-7

Keywords: tracheal stenosis, post-intubation, COVID-19, retrospective cohort, bronchoscopic treatment, surgical outcomes, pulmonary medicine, mechanical ventilation, Long-term, outcomes, COVID-19-related, versus