A prospective study of complications of tracheostomy and management in tertiary care hospital in rural area

Abstract

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">The present study was carried out with an objective to study the various </span><span lang="EN-IN">indications and prevalence of tracheostomy, appropriate time to perform it, and complications arising during and after the procedure and their modes of managements. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A prospective and interventional study was carried out in ENT department during the period from Aug 2012 to May 2014. Total 124 patients (both pediatric and adult) undergoing tracheostomies for various indications were studied. The details of all participants such as demographic data, indications of tracheostomy, intra and postoperative complications were recorded and management of complications (if any) was done. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The prevalence of tracheostomy was 0.253% for given study period and was performed more commonly in young adults (15-50 years). Males were more commonly subjected to tracheostomy as compared to females. Planned tracheostomies were more frequently performed, as most common indication of tracheostomy was assisted ventilation both in adult and children. The incidence of complications in intra and postoperative period was 29.81% (37 patients), the majority happening during the early postoperative period. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">The study concluded that the tracheostomy was more commonly perform in young adults with higher prevalence among male subjects. The main indication for tracheostomy in adult and children was assisted ventilation whereas most common complications were subcutaneous emphysema and peristomal infections. Most of the complications were managed conservatively.</span></p>

A clinical study on the outcomes of tracheostomy in a tertiary care center: a prospective observational study

“…Total 81 patients who had undergone tracheostomy in this tertiary care centre, 58 patients were male (72%) and 23 patients were females (29%). This was in accordance with the similar study conducted by Kawale et 9 This could be because of the advancement and improvement in the management of critically ill patients compared to previous era, in which young age group shows more response and speedy recovery. The most common indication for tracheostomy in this study was prolonged ventilation (54.0%), secondary to traumatic brain injury and acute stroke, which was in agreement with the study conducted by Goldenberg et al who had reported the commonest indication of tracheostomy as prolonged mechanical ventilation.…”

Tracheostomy-related indications, early complications and their predictors among patients in low resource settings: a prospective cohort study in the pre-COVID-19 era

“…The 53% incidence of early tracheostomy-related complications documented in this study, although in alignment with the global estimated range of 6 to 66%, is higher than the 21.5% reported in Tanzania [7]. Similarly, this incidence is higher than what has been reported in previous studies from comparable settings such as Nigeria where this rate ranged between 10.3% and 21% [6,20] and India (29.8%) [24]. Lower complication rates (15%) have been documented in high income settings such as Finland [25].…”

“…4 Department of Anatomy, Mbarara University of Science and Technology, Mbarara, Uganda. 5 Department of Pediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda.…”

“…The many benefits of tracheostomy have led to a global upward trend in the frequency of the procedure with up-to 250,000 procedures currently performed annually in resource-rich countries [4] and indications are being continuously revised. In literature, this rising trend has been attributed to increased access to better intensive care services [5] and changes in the epidemiology of upper airway obstructive conditions [6]. In the past, obstructive airway disease secondary to acute aero-digestive infections was the most common indication, but in the recent pre-COVID-19 years, trauma and aero-digestive tumors have dominated the list [6][7][8].…”

Timing of Tracheostomy and Outcomes in Adults with Moderate and Severe Tetanus

“…9,10 Only 35.8% (n=39) of our patients were admitted in an intensive care facility similar to findings of another local study, reflecting the limited resources and inadequate care for most of these patients. 11,12 In contrast, earlier studies that recommend intensive care unit (ICU) admission have shown satisfactory outcomes in the treatment of tetanus patients. [13][14][15] Our study has several limitations.…”