Audit of Tracheostomy Decannulation in a Suburban Tertiary Care Hospital

Tracheostomy decannulation is the process of re-establishment of normal naso tracheal ventilation in a patient undergoing tracheostomy. Success rates for decannulation show wide variations. This study audited the outcome of tracheostomy decannulation in an African cohort managed in a tertiary healthcare facility.

The charts and records of patients who underwent tracheostomy decannulation in a 10-year period were retrieved. The primary outcome measure was successful decannulation. The relationship between successful decannulation and patients' sociodemographic variables, pre tracheostomy endotracheal intubation, duration of intubation, duration of tracheostomy, and indications for tracheostomy was determined using inferential statistics.

A total of 38 patients were admitted for decannulation during the period. Bypass of upper airway obstruction was the commonest indication for tracheostomy (60.5%), followed by mechanical ventilation (34.2%). Only 20 (52.6%) patients were successfully decannulated at the first attempt. An additional six patients were decannulated after various secondary procedures, giving an overall successful decannulation rate of 68.42%. Preoperative endotracheal intubation and duration of endotracheal intubation were significant predictors of failed decannulation.

We conclude that primary decannulation is successful in about half of the patients adjudged qualified for such in our practice; this increases to 68.4% with the secondary procedure.