Outcomes of Covid-19 Patients Who Underwent Tracheostomies

ABSTRACT

INTRODUCTION: Tracheostomy is the most frequent surgical procedure performed in critically ill patients, mostly in patients requiring prolonged mechanical ventilation. We aimed to describe the outcomes associated with tracheostomies in critically ill COVID-19 patients admitted to our ICU. METHOD(S) We studied a cohort of adult patients admitted with the diagnosis of COVID-19 to a mixed ICU between 03/2020 and 06/2021. We collected patients' demographics, severity of illness, ICU resource utilization, and outcomes. Descriptive statistics were reported. RESULT(S) A total of 275 patients with confirmed COVID-19 were admitted to our ICU during the study period. Among them, 26 patients (9.45%) underwent tracheostomy. There were 10 females (38.4%) with an average age of 60 years (range 53-67). Median body mass index was 31 (range 26-41). Patients identified themselves as African American (39%), Caucasian (27%), and the remaining as other or declined to answer. Median Sequential Organ Failure Assessment (SOFA) score on admission was 10 (range 8-12) and max SOFA score was 13 (range 11-17). Mean mechanical ventilation-days was 19 days (range 12-23). Median ICU length of stay (LOS) was 41 days (range 31-48) and hospital LOS was 46 days (range 32-60). The ICU and hospital mortality rates were 23% and 27% respectively. There were no procedural causes of death. CONCLUSION(S) Although the mortality of the patients that underwent tracheostomies was relatively high, these patients were less than 3% of the total cohort of COVID-19 patients admitted to the ICU and had lower mortality than expected adjusted for their severity of illness based on the SOFA score.