FREQUENCY OF POST-TRACHEOSTOMY COMPLICATIONS IN INTENSIVE CARE UNIT PATIENTS

Abstract

Background: Tracheostomy is a commonly performed procedure in intensive care unit (ICU) patients requiring prolonged airway support or mechanical ventilation. Although it provides several clinical benefits, it may be associated with a range of early and late complications that can increase patient morbidity and affect clinical outcomes. Objective: To determine the frequency of post-tracheostomy complications in intensive care unit patients. Methods: A prospective observational study was conducted among 61 ICU patients who underwent surgical tracheostomy at Lady Reading Hospital and Hayatabad Medical Complex, Peshawar, between July and December 2024. Patients were followed daily for the occurrence of post-tracheostomy complications. Data were collected using a structured questionnaire and analyzed in SPSS version 22.0 using descriptive statistics and chi-square test. A p-value <0.05 was considered statistically significant. Results: A total of 61 ICU patients who underwent tracheostomy were included in the study. Among them, 57.4% were male and 42.6% were female, with the majority aged 20–40 years (42.6%). The most common post-tracheostomy complication was ventilator-associated pneumonia (14.8%), followed by bleeding complications (9.8%). Pneumothorax and tracheoesophageal fistula were each observed in 6.6% of patients, while subcutaneous emphysema, sepsis, and cardiopulmonary arrest occurred in 4.9% of patients. Less frequent complications included vocal cord paralysis (3.3%), difficulty in speaking (1.6%), accidental Decannulation (1.6%), laryngeal edema (1.6%), and difficulty in swallowing (1.6%). No case of tracheal stenosis was observed. Conclusion: Post-tracheostomy complications were not uncommon among ICU patients, with ventilator-associated pneumonia and bleeding being the most frequent complications. Early recognition and standardized post-tracheostomy care may help reduce complication rates and improve patient outcomes in critically ill patients.

Keywords: Frequency, Post-Tracheostomy, Complications, and Intensive Care Units.