Background: Tracheostomy can be performed safely in patients with coronavirus disease 2019 (COVID-19). However, little is known about the optimal timing, effects on outcome, and complications. Methods: A multicenter, retrospective, observational study. This study included 153 tracheostomized COVID-19 patients from 11 intensive care units (ICUs). The primary endpoint was the median time to tracheostomy in critically ill COVID-19 patients. Secondary endpoints were survival rate, length of ICU stay, and post-tracheostomy complications, stratified by tracheostomy timing (early versus late) and technique (surgical versus percutaneous). Results: The median time to tracheostomy was 15 (1-64) days. There was no significant difference in survival between critically ill COVID-19 patients who received tracheostomy before versus after day 15, nor between surgical and percutaneous techniques. ICU length of stay was shorter with early compared to late tracheostomy (p < 0.001) and percutaneous compared to surgical tracheostomy (p = 0.050). The rate of lower respiratory tract infections was higher with surgical versus percutaneous technique (p = 0.007). Conclusions: Among critically ill patients with COVID-19, neither early nor percutaneous tracheostomy improved outcomes, but did shorten ICU stay. Infectious complications were less frequent with percutaneous than surgical tracheostomy.
Tracheostomy Timing and Outcome in Severe COVID-19: The WeanTrach Multicenter Study / Battaglini, Denise; Missale, Francesco; Schiavetti, Irene; Filauro, Marta; Iannuzzi, Francesca; Ascoli, Alessandro; Bertazzoli, Alberto; Pascucci, Federico; Grasso, Salvatore; Murgolo, Francesco; Binda, Simone; Maraggia, Davide; Montrucchio, Giorgia; Sales, Gabriele; Pascarella, Giuseppe; Agrò, Felice Eugenio; Faccio, Gaia; Ferraris, Sandra; Spadaro, Savino; Falò, Giulia; Mereto, Nadia; Uva, Alessandro; Maugeri, Jessica Giuseppina; Agrippino, Bellissima; Vargas, Maria; Servillo, Giuseppe; Robba, Chiara; Ball, Lorenzo; Mora, Francesco; Signori, Alessio; Torres, Antoni; Giacobbe, Daniele Roberto; Vena, Antonio; Bassetti, Matteo; Peretti, Giorgio; Rocco, Patricia R M; Pelosi, Paolo. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 10:12(2021), p. 2651. [10.3390/jcm10122651]
Tracheostomy Timing and Outcome in Severe COVID-19: The WeanTrach Multicenter Study
Vargas, Maria;Servillo, Giuseppe;
2021
Abstract
Background: Tracheostomy can be performed safely in patients with coronavirus disease 2019 (COVID-19). However, little is known about the optimal timing, effects on outcome, and complications. Methods: A multicenter, retrospective, observational study. This study included 153 tracheostomized COVID-19 patients from 11 intensive care units (ICUs). The primary endpoint was the median time to tracheostomy in critically ill COVID-19 patients. Secondary endpoints were survival rate, length of ICU stay, and post-tracheostomy complications, stratified by tracheostomy timing (early versus late) and technique (surgical versus percutaneous). Results: The median time to tracheostomy was 15 (1-64) days. There was no significant difference in survival between critically ill COVID-19 patients who received tracheostomy before versus after day 15, nor between surgical and percutaneous techniques. ICU length of stay was shorter with early compared to late tracheostomy (p < 0.001) and percutaneous compared to surgical tracheostomy (p = 0.050). The rate of lower respiratory tract infections was higher with surgical versus percutaneous technique (p = 0.007). Conclusions: Among critically ill patients with COVID-19, neither early nor percutaneous tracheostomy improved outcomes, but did shorten ICU stay. Infectious complications were less frequent with percutaneous than surgical tracheostomy.File | Dimensione | Formato | |
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