Tuberc Respir Dis.  2020 Apr;83(2):167-174. 10.4046/trd.2019.0082.

Effect of Early Tracheostomy on Clinical Outcomes in Patients with Prolonged Acute Mechanical Ventilation: A Single-Center Study

Affiliations
  • 1Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea. jubilate@pusan.ac.kr
  • 2Department of Trauma Surgery, Pusan National University School of Medicine, Busan, Korea.
  • 3Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Busan, Korea.
  • 4Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo, Korea.

Abstract

BACKGROUND
The purpose of this study was to investigate the effect of early tracheostomy on clinical outcomes in patients requiring prolonged acute mechanical ventilation (≥96 hours).
METHODS
Data from 575 patients (69.4% male; median age, 68 years), hospitalized in the medical intensive care unit (ICU) of a university-affiliated tertiary care hospital March 2008-February 2017, were retrospectively evaluated. Early and late tracheostomy were designated as 2-10 days and >10 days after translaryngeal intubation, respectively.
RESULTS
The 90-day cumulative mortality rate was 47.5% (n=273) and 258 patients (44.9%) underwent tracheostomy. In comparison with the late group (n=115), the early group (n=125) had lower 90-day mortality (31.2% vs. 47.8%, p=0.012), shorter stays in hospital and ICU, shorter ventilator length of stay (median, 43 vs. 54; 24 vs. 33; 23 vs. 28 days; all p<0.001), and a higher rate of transfer to secondary care hospitals with post-intensive care settings (67.2% vs. 43.5% p<0.001). Also, the total medical costs of the early group were lower during hospital stays than those of the late group (26,609 vs. 36,973 USD, p<0.001).
CONCLUSION
Early tracheostomy was associated with lower 90-day mortality, shorter ventilator length of stay and shorter lengths of stays in hospital and ICU, as well as lower hospital costs than late tracheostomy.

Keyword

Mortality; Mechanical Ventilation; Tracheostomy

MeSH Terms

Hospital Costs
Humans
Intensive Care Units
Intubation
Length of Stay
Male
Mortality
Respiration, Artificial*
Retrospective Studies
Secondary Care
Tertiary Healthcare
Tracheostomy*
Ventilators, Mechanical
Full Text Links
  • TRD
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error