COVID-19 Tracheostomy Outcomes.
Otolaryngol Head Neck Surg
; 167(6): 923-928, 2022 Dec.
Artículo
en Inglés
| MEDLINE | ID: covidwho-2272640
ABSTRACT
OBJECTIVES:
(1) Assess overall COVID-19 mortality in ventilated patients with and without tracheostomy. (2) Determine the impact of tracheostomy on mechanical ventilation duration, overall length of stay (LOS), and intensive care unit (ICU) LOS for patients with COVID-19. STUDYDESIGN:
Case series with planned chart review.SETTING:
Single-institution tertiary care center.METHODS:
Patients with COVID-19 who were ≥18 years old and requiring invasive positive pressure ventilation (IPPV) met inclusion criteria. Patients were stratified into 2 cohorts IPPV with tracheostomy and IPPV with intubation only. Cohorts were analyzed for the following primary outcomemeasures:
mortality, LOS, ICU LOS, and IPPV duration.RESULTS:
An overall 258 patients with IPPV met inclusion criteria 46 (18%) with tracheostomy and 212 (82%) without (66% male; median age, 63 years [interquartile range, 18.75]). Average LOS, time in ICU, and time receiving IPPV were longer in the tracheostomy cohort (P < .01). Ability to wean from IPPV was similar between cohorts (P > .05). The number of deaths in the nontracheostomy cohort (54%) was significantly higher than the tracheostomy cohort (29%, P < .01).CONCLUSIONS:
While tracheostomy placement in patients with COVID-19 did not shorten overall LOS, mechanical ventilation duration, or ICU LOS, patients with a tracheostomy experienced a significantly lower number of deaths vs those without. One goal for tracheostomy is improved pulmonary toilet with associated shortened IPPV requirements. Our study did not identify this advantage among the COVID-19 population. However, this study demonstrates that the need for tracheostomy in the COVID-19 setting does not portent a poor prognostic factor, as patients with a tracheostomy experienced a significantly higher survival rate than their nontracheostomy counterparts.Palabras clave
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Traqueostomía
/
COVID-19
Tipo de estudio:
Estudio de cohorte
/
Estudio observacional
/
Estudio pronóstico
Límite:
Adolescente
/
Femenino
/
Humanos
/
Masculino
/
Middle aged
Idioma:
Inglés
Revista:
Otolaryngol Head Neck Surg
Asunto de la revista:
Otorrinolaringologia
Año:
2022
Tipo del documento:
Artículo
País de afiliación:
01945998221075610
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