Comparison Between Complications of Elective and Emergency Tracheostomies

Naeema Natasha; Saleh Khurshied; Muhammad A Zahid; Nawal Khurshid; Altaf Hussain; Muhammad A Khizer; Maesum Ali

doi:10.7759/cureus.48612

Comparison Between Complications of Elective and Emergency Tracheostomies

Cureus. 2023 Nov 10;15(11):e48612. doi: 10.7759/cureus.48612. eCollection 2023 Nov.

Authors

Naeema Natasha¹, Saleh Khurshied², Muhammad A Zahid³, Nawal Khurshid², Altaf Hussain², Muhammad A Khizer^{4

5}, Maesum Ali²

Affiliations

¹ Otolaryngology - Head and Neck Surgery, Pakistan Institute of Medical Science, Islamabad, PAK.
² Otolaryngology - Head and Neck Surgery, Pakistan Institute of Medical Sciences, Islamabad, PAK.
³ Ophthalmology, Monash Health, Clayton, AUS.
⁴ Ophthalmology, National University of Medical Sciences, Rawalpindi, PAK.
⁵ Ophthalmology, Armed Forces Institute of Ophthalmology, Rawalpindi, PAK.

Abstract

Introduction Tracheostomy, although a common surgical procedure, is associated with potential complications. Complications can be avoided with accurate technique and proper operative and postoperative care. A surgeon should know the complications of the procedure and how to avoid them so that complications may be prevented or minimized. Objective To determine the frequency of complications in patients undergoing elective and emergency tracheostomies. Methods The cross-sectional study was conducted at the Department of Otorhinolaryngology - Head and Neck Surgery, and Intensive Care Unit (ICU) of PIMS Hospital, Islamabad, from March 1 to August 31, 2023, with a total duration of six months. A total of 110 patients admitted to the ICU and presented in an emergency falling within the inclusion criteria were counted in the study. Patients were split into two groups, i.e., elective tracheostomy (group A) and emergency tracheostomy (group B). All patients were followed for three months for adverse events related to the tracheostomy. All information was collected on Proforma and analyzed using the SPSS 23 version (IBM Corp., Armonk, NY). Results The mean age of participants was 48.47±12.68 years in group A and 49.54±10.99 years in group B (p=0.636). 40 (72.7%) and 37 (67.3%) patients were male and 15 (27.3%) and 18 (32.7%) female in groups A and B, respectively. The results of post-operative complications in both groups A and B were observed, respectively, for surgical emphysema (2 [3.6%] vs. 5 [9.1%], p=0.241), hemorrhage (2 [3.6%] vs. 4 [7.3%], p=0.401), wound infection (3 [3.6%] vs. 6 [10.9%], p=0.279), tube blockage (0 [0.0%] vs. 1 [1.8%], p=0.315), tube displacement (0 [0.0%] vs. 3 [5.5%], p=0.079), and tracheoesophageal fistula (0 [0.0%] vs. 2 [3.6%], p=0.154). The overall complications in elective tracheostomies were 7 (12.7%) and in emergency tracheostomies were 21 (38.2%). Conclusion We concluded that patients who had an emergency tracheostomy experienced more postoperative complications than those who underwent an elective tracheostomy.

Keywords: emergency and elective surgery; icu( intensive care unit ); otolaryngology head and neck; post op complication; tracheostomy.