Magnitude of tracheal stenosis and contributing factors among adult intubated patients in intensive care units in Northern Ethiopia

Tracheal stenosis is a potentially life-threatening complication of endotracheal intubation associated with significant morbidities. However, its burden is not well studied in developing countries. This study aimed to assess the frequency of clinically detected tracheal stenosis and its associated factors among adult patients who underwent intubation in ICUs in Northern Ethiopia. A hospital-based cross-sectional study was conducted using retrospective chart review of adult intubated patients between September 01 and August 30, 2022, at Ayder Comprehensive Specialized Hospital (ACSH), Ethiopia. Of the total 376 intubated patients admitted to surgical and medical ICUs, 151 were included in the study. Diagnosis of tracheal stenosis was based on clinically bronchoscopic findings, and no systematic screening protocol was applied. Data were extracted from the patients’ medical charts. Bivariate and multivariable Firth logistic regression analyses were performed to identify factors associated with tracheal stenosis. Possible effects of confounders were controlled during regression analysis, and a p -value of < 0.05 was considered statistically significant for predictors. A total of 151 intubated patients were included in the analysis. The most common admission diagnosis was trauma (51.7%). Thirteen patients (8.6%) were diagnosed with tracheal stenosis based the documented bronchoscopic findings. The majority of patients admitted to the the adult ICUs were transferred to the wards 93 (61.6%), while 54 patients (35.8%) died. Multiple intubations were observed in 10.6% of patients. Patient age, admission diagnosis, presence of tracheostomy, multiple intubations, and prolonged intubation were associated with the development of tracheal stenosis. In the multivariable analysis, prolonged intubation was the only factor that remained statistically significant. Patients with prolonged intubation periods had seven times higher odds of developing tracheal stenosis independently. The frequency of clinically detected of tracheal stenosis among adult ICU patients was high, occurring in approximately one out of every twelve patients. A prolonged intubation was associated with tracheal stenosis. Improving the quality of care for intubated patients is essential to reduce the burden of tracheal stenosis and its associated adverse outcomes.