COMPLICATIONS OF TRACHEOSTOMY IN PATIENTS PRESENTING TO A TERTIARY CARE HOSPITAL: A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Background: A tracheostomy is a frequently performed surgical procedure for creating a secure airway in a patient who has an upper airway obstruction or is on prolonged mechanical ventilation. Although safe overall, it can be linked to several early and late complications after surgery that can cause patients to experience increased morbidity. Assessing the incidence and risk factors for these complications is crucial to enhancing surgical success and recovery. Methods: After obtaining ethical approval, this prospective observational study was done in the Department of Otorhinolaryngology of Hayatabad Medical Complex, Peshawar, period of 20 February 2023 to 19 August 2023. Total of 96 consecutive patients undergoing elective or emergency tracheostomy were included in the study using consecutive non-probability sampling technique. The data on demographic, clinical, operative and postoperative was obtained prospectively. Data were analysed by SPSS version 26.0. A Chi-square or Fisher's exact test was used to compare categorical variables, and a p-value of < 0.05 was deemed significant. Results: The mean age of participants was 49.8 ± 17.2 years, and 62.5% were male. Total, 27 (28.1%) patients had postoperative complications. Tube obstruction (7.3%) was the most frequent complication, followed by wound infection (6.3%), postoperative bleeding (4.2%) and accidental decannulation (4.2%). Emergency tracheostomy (p = 0.014), diabetes mellitus (p = 0.009), longer operative time (p = 0.028), and procedures performed by resident surgeons (p = 0.037) were significant factors associated with postoperative complications, while age and gender were not. Conclusion: Tracheostomy is a safe and effective airway procedure with an acceptable complication rate if it is performed according to a standardized surgical procedure. Appropriate and thorough patient management, careful surgical technique, adequate operator training and thorough post-op management can minimize preventable complications and enhance patient results.