Tracheostomy in Covid-19 Patients: A Retrospective Observational Study

Abstract

Objective: During the COVID-19 pandemic, many patients require intensive care unit (ICU) hospitalization with mechanical ventilation (MV). There is still no clear information about the timing and indications of tracheostomy in COVID-19 cases. We aimed to evaluate the relationship between the timing of tracheostomy and outcomes of critical COVID-19 cases. Materials and Methods: This single-center, retrospective, observational study included patients with COVID-19 who were intubated in the ICU between November 1, 2020 and February 1, 2021, and underwent percutaneous tracheostomy. Demographic data of all patients, the day each patient underwent a percutaneous tracheostomy, the complications related to the procedure, laboratory data, mortality, MV duration, and ICU length of stay (LOS) were recorded. Results: The study included 33 critically ill patients with COVID-19 undergoing tracheostomy. Among these cases, 18 (54.5%) patients who underwent tracheostomy within 14 days after intubation comprised the early group; 15 (45.5%) patients who underwent tracheostomy after 14 days comprised the late tracheostomy group. There was no difference between the two groups in mortality. The median ICU LOS was 33.0 (25.0–37.0) days, and it was longer in late group [35.0 (30.0–37.0) vs. 29.5 (18.8–34.5), p=0.046]. The median duration of MV was 27.0 (18.0–33.5) days, which was longer in late group [29 (25.0–37.0) vs. 19 (12.8–29.0), p=0.004]. Conclusion: In critical COVID-19 cases, there was no difference between groups in terms of mortality. In the early tracheostomy group, ICU LOS and the MV duration were significantly shorter.