Abstract:

Background: Tracheostomy is a lifesaving procedure used globally. As with other surgeries open surgical tracheostomies do not go without risks and complications. Tracheostomy has frequently found to develop complications than most of surgeries.

Objective: The aim of this study was to determine the common indications and predictors of early complications among patients undergoing open tracheostomies at Bugando Medical Centre, Mwanza, Tanzania from January to June 2019.

Methods: This was a hospital based prospective cross sectional study that included 56 patients who underwent open tracheostomy at Bugando Medical Centre from January to July 2019. Data collected were demographic information and clinical details. Detailed history taking and thorough physical examination were done to determine diagnosis and indications for tracheostomy. After tracheostomy surgery characteristics were determined and patients were followed up for seven days to determine complications. To determine the predictors of early complications of open tracheostomy univariate logistic analysis followed by multivariate logistic regression analysis were performed.

Results: A total of 56 patients were recruited and their data analysed, age ranged from 14days- 80years, and mean age of 39.26 ± 20.64years. There were 41 (73.2%) males and 15 (26.8%) females with M:F ratio of 2.7:1. Majority of the patients were in the 3rd decade. About 31 (55.4%) had elective tracheostomy. The commonest major group indication for tracheostomy was upper airway obstruction 27 (48.2%) followed prolonged intubation 19 (33.4%), adjunct to major head and neck surgery 7 (12.5%) and airway protection 3 (5.4%). The complications rate are the same in both emergency and elective group of 16%. The complications recorded were tracheostomy tube blockage 9 (42.8%), false tracheostomy 3 (14.3%), wound infection 3 (14.3%), surgical emphysema 2 (9.5%), death 2 (9.5%), haemarrhage 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 in the univariate logistic regression and none in multivariate logistic regression. Overall 3.6% tracheostomy related mortality was recorded.

Conclusion: The most common major groups of indications is 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. Therefore efforts should invested to doctors and nurses to meticulously perform tracheostomies and on the care of tracheostomy respectively to mitigate the complications occurrence.