Factors induce tracheostoma hypergranulation

Abstract

Objective: To evaluate the factors induce tracheostoma hypergranulation, incidence of bacteria of tracheostoma hypergranulation and type with drug sensitivity of     bacteria of tracheostoma hypergranulation. Methods: The study was descriptive study. It was conducted at the King Chulalongkorn Memorial Hospital in Bangkok, Thailand. Total   number of 100 patients were enrolled between February 2019 and May 2020. The data was concluded by history taking and physical examination, assessing factors induce tracheostoma hypergranulation include underlying diseases, length of tracheostomy tube used, history of antibiotic used within 1 month, history of stoma infection   pneumonia or sepsis within 1 month, material of tracheostomy tube, cuff status,   diameter of tracheostomy tube, frequency of inner tube cleaning and stoma status at visit period. In case of hypergranulation at stoma, biopsy was done to evaluate the type        and drug sensitivity of organism. Results: Among total of 100 patients, factor induce stoma hypergranulation include history of antibiotic used within 1 month (OR 4.04 [1.22- 13.43], P= 0.023), tracheostomy tube with cuff (OR 6.25 [2.26-17.29], P <0.001), larger diameter of tracheostomy tube (OR 4.12 [1.61-10.56], P=0.003) and low frequency of inner tube cleaning (OR 5.27 [1.08-25.78], P=0.04) Incidence of bacteria of tracheostoma         hypergranulation is 38.89% (14 from 36 patients), mixed types of bacteria were identified  inside. According to mixed types of bacteria inside hypergranulation, drug sensitivity of bacteria wasn’t performed. Conclusion: History of antibiotic used within 1 month, tracheostomy tube with cuff, larger diameter of tracheostomy tube and low frequency of inner tube cleaning are significant associated with tracheostoma hypergranulation.The incidence of bacteria inside granulation is 38.89% mix types of bacteria were identified.