Tracheostomy is regarded as a life saving surgical procedure throughout the world and particularly in our environment where patients present late in upper airway obstruction. Few work has been done on tracheostomy, therefore it was essential to conduct this study to describe our own experiences with tracheostomy, outlining the common indications and outcome of tracheostomized patients in our setting and compare our results with those from other hospitals in the world.
This was a retrospective study which was conducted at Dhaka Medical College Hospital from July 2014 to June 2019. Data were retrieved from Emergency & Indoor Patient register, emergency OT, elective OT, ICU, as well as patients files kept in Medical record department . Data were analyzed using SPSS computer software. Ethical approval to conduct the study was obtained from relevant authority before the commencement of the study.
Total 257 patients were studied. Male to female ratio was 4.47:1. Majority of the patients were in the sixth decade of life. Commonest indication for tracheostomy were upper airway obstruction secondary to neoplastic cause in 70.04% of patients, followed by upper airway obstruction secondary to traumatic causes in 24.9% cases. Majority of the tracheostomies 82.88% were performed as an emergency. Mostly longitudinal, otherwise transverse skin crease incision was employed in all cases. Post tracheostomy complication rate was 18.68%. Complication rate was higher in emergency tracheostomy than in electives. Duration of temporary tracheostomy ranged from 5 days to 42 months, with a median duration of 3 months. Decannulation of tracheostomy was successively performed in 77.82% patients who survived. 10.89% was the mortality rate. Mortality was not related to tracheostomy, but for their underlying illnesses.
Upper airway obstruction secondary to laryngeal tumours and secondary trauma still remains the commonest indication for tracheostomy in our hospital. Most of the tracheostomy related complications can be avoided by meticulous attention to the details of surgical technique and postoperative care by skilled and trained doctor, nurse and supporting staff .