TITLE:
Indications and Predictors of Early Complications among Patients Undergoing Open Tracheostomies at a Tertiary Hospital, Northwest Tanzania
AUTHORS:
Rogers Machimu, Japhet Gilyoma, Alex donasiano, Samson Kichiba, Cecilia Protas, Gustave Buname
KEYWORDS:
Tracheostomy, Early Complications, Predictors
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.14 No.2,
March
14,
2025
ABSTRACT: Background: Tracheostomy is a lifesaving procedure used globally. As with other surgeries open, surgical tracheostomies do not go without risks and complications. The aim of this study was to determine the common indications and predictors of early complications among patients undergoing open tracheostomies. Methods: This was a prospective cross sectional study that included 56 patients who underwent open tracheostomy at Bugando Medical Centre from January to July 2019. After tracheostomy, characteristics were determined, and patients were followed up for seven days to determine complications. Univariate logistic analysis followed by multivariate logistic regression analysis was performed to determine predictors of early complications. Results: The age ranged from 14 days – 80 years, and median 40 years. Male were 41 (73.2%) and 15 (26.8%) females. About 31 (55.4%) had elective tracheostomy. The commonest indications were upper airway obstruction 27 (48.2%), prolonged intubation 19 (33.4%), adjunct to major head and neck surgery 7 (12.5%) and airway protection 3 (5.4%). The complications rate was 32% and recorded tracheostomy tube blockage 9 (42.8%), false tracheostomy 3 (14.3%), wound infection 3 (14.3%), surgical emphysema 2 (9.5%), apnea 2 (9.5%), haemorrhage 1 (4.8%) and tube dislodgement 1 (4.8%). Increased age (OR 1.3; 95% CI 1.00 - 1.06; p = 0.048) was the only significant factor. Overall, 3.6% tracheostomy related mortality was recorded. Conclusion: The most common indications are upper airway obstruction followed by prolonged intubation, adjunct to head and neck surgery and lower airway protection. The most common complications were tracheostomy tube blockage, false tracheostomy and wound infections. Increased age was the only significant predictor.