This was a 10-year study done at a tertiary care teaching hospital in Tanzania and included 214 patients. Male to female ratio was 3:1, with a mean age of 38 years.
In their study, the most common indication for tracheostomy was upper airway obstruction secondary to trauma or neoplastic causes. Eighty-six percent of tracheostomies were temporary, and 14% were permanent tracheostomies.
Most (80%) of these tracheotomies were performed as an emergency and the complication rate was higher in that group, compared to the overall complication rate (74% vs. 21.5%).
Twenty-two percent of complications occurred in the first
postoperative week, and 65% occurred after the first postoperative week. Of the patients who had a tracheostomy placed for prolonged mechanical ventilation, the duration of intubation before tracheostomy ranged from 4-62 days, with a median of 26 days.
Duration of cannulation was 8 days to 46 months, with a median duration of 4 months.
Decannulation was successful in 72% of patients who survived.
Mortality rate was 13.6% and was due to the underlying illness, not the tracheostomy itself.
As the authors stated, and I would agree, that the majority of the complications can be prevented by meticulous attention to technique and postoperative care.
Source: Gilyoma, J.,Balumuka, D, Chalya, P. (2011). Ten-year experiences with tracheostomy at a university teaching hospital in northwestern Tanzania: A retrospective review of 214 cases. World J Emerg Surg, 6:38.
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