Incidence of complications of emergency tracheostomy in a rural medical college setting: a prospective study

Abstract

<p><strong>Background: </strong>Tracheostomy done as an emergency procedure for the purpose of saving lives, is mostly associated with aerodigestive tract malignancies, though a few may be associated with foreign body aspiration. The incidences of complications intraoperatively as well as postoperatively are high in emergency tracheostomies. Few studies exist documenting the incidence of these complications .Thus this study was undertaken in a rural Medical College setting to find the incidence of complications associated with emergency tracheostomy.</p><p><strong>Methods: </strong>After Institutional ethical committee clearance, a prospective study was conducted over a period of 2 years which included 120 patients of all ages and both genders, who presented to the emergency room with stridor. All tracheostomies were performed, using standard techniques, in the emergency operation theatre under monitored anaesthesia care or general anaesthesia. Complications were noted during the procedure as well as in the postoperative period at regular intervals upto one year and were categorized as immediate, intermediate and late.</p><p><strong>Results: </strong>Though there was no case of mortality, the incidence of complications was 53.3%. The commonest immediate complication was haemorrhage (12.5%) followed by cardiopulmonary arrest (5%) and apnoea (3.3%). The commonest intermediate complications were infection (18.3%), crusting (12.5%), displacement of tube (8.3%) and bleeding (8.3%).Late complications noted were stomal stenosis (8.3%), keloid formation (5%) and tracheocutaneous fistula (3.3%).</p><p class="abstract"><strong>Conclusions: </strong>Some of these complications can be avoided by early intervention as a semi emergency procedure when you first think about it. This can avoid the hazzle of hurried tracheostomy in a struggling patient thus bringing down the incidence of complications.</p>