Assessment of Dyspnea in Patients Undergoing Tracheostomy: A Correlation Cohort Study Using the Modified Medical Research Council Scale

Purpose: The aim of this study is to explore the association between patient-reported dyspnea and objective functional and structural airway findings in a post-tracheostomy population, and to compare these relationships between open surgical and percutaneous dilatational tracheostomy. Methods: The prospective, single-center, observational cohort study included 156 patients evaluated in the late post-tracheostomy period. Dyspnea severity was assessed using modified Medical Research Council (mMRC) scale. All patients underwent spirometry (measuring vital capacity [VC] and FEV1/VC ratio) and neck and chest computed tomography (CT). Patients were divided into two groups based on tracheostomy type: open surgical tracheostomy (OST, n=76) and percutaneous dilatational tracheostomy (PDT, n=80). Associations between mMRC scores, spirometry patterns, and CT-defined tracheal stenosis were analyzed using Spearman correlation and ordinal logistic regression. Results: Most patients in both groups reported minimal dyspnea (mMRC=0: OST 56.6%, PDT 43.7%). Spirometric abnormalities were observed in both groups without significant intergroup differences. Restrictive patterns were more common in the PDT group; obstructive patterns predominated in the OST group. CT-defined tracheal stenosis was present in 28.0% of OST and 31.3% of PDT patients, with higher- grade stenosis observed only in the PDT group. mMRC scores were significantly associated with spirometric category (ρ = 0.343, p < 0.001) and CT stenosis grade (ρ = 0.461, p < 0.001), but not with the FEV₁/VC ratio. Conclusion: In post-tracheostomy patients, dyspnea severity assessed by the mMRC scale was associated with both functional and structural airway findings. These associations are biologically expected and consistent with observations in other airway diseases, but are demonstrated here in a specific and under-studied post-tracheostomy population. The results should be interpreted as descriptive and exploratory rather than indicative of diagnostic or screening utility. Clinical trial registration: Trial “Quality of life in patients undergoing tracheostomy” was registered in ISRCTN24668317 (IRB no. YSMU №7/18–19) with date of registration April 23, 2019