Epidemiological pattern and clinical indications for tracheostomy at Bugando Medical Centre Mwanza Tanzania

Abstract

Background: Tracheostomy is among the first surgical procedures done by man and is performed from generation to generation with the major reason of saving lives. In Tanzania this procedure is commonly done and in the medical universities is taught as one of the procedures that all doctors should know. Tracheostomy is a common emergency lifesaving procedure performed between 21 to 25 patients per year among all patients receiving ENT services (13, 14). Though there is a scarcity in recent data and literature on the magnitude of tracheostomies performed in the lake zone.
The most common indication for tracheostomy varies in studies from upper airway obstruction due to trauma, neoplasm, or prolonged intubation (13, 14). The pattern of tracheostomy indications may have changed with time due to advancement in medical practice. However, we lack current data in our setting highlighting indications for tracheostomies performed
Methodology: This study aims at finding the epidemiological pattern and clinical indications for tracheostomy patients attending at Bugando medical centre. The engagement was done in a zonal referral hospital serving 6 regions of the country. This is a descriptive cross-sectional study which spanned from September 2023 to May 2024.
Results: The total number of patients was 35 whereby males were 51.4%(18) and females 48.6% (17).Number of males was slightly higher compared to females by 1.1%.The median age for the patient was 23 years, with the mean age of 20 years. The leading age group with the largest number of patients was 50 to 59 years. Most patients came from rural areas 74 %(26). Among clinical indications for tracheostomy the leading was upper airway obstruction by 65.7%, within which malignancy predominated other conditions by 65.2%, followed by trauma 26.1%, then prolonged intubation. Females showed a significant predominant distribution of malignancies of head and Neck by 60% which were evenly distributed in varying head and neck sites with p value of 0.039 which is statistical significant; with exception of laryngeal malignancies which were observed in males alone accounting for 26.7% in the whole study period.
In conclusion this study shows the prevalence of tracheostomy in our environment, which is 1.8% and the clinical indication pattern has changed from trauma in previous studies to upper airway obstruction secondary to neoplastic conditions. It also shows the significance of site of malignancy to its relation to gender and this findings are not found in other studies.
Recommendation: Molecular studies are needed to analyze further the differences in subsite in terms of gender.