Frequency and Timing of Tracheostomy and its Impact on clinical outcome in Patients with Covid-19 admitted in ICU

Abstract

The COVID-19 pandemic has become one of the main challenges of the health care system in recent years. A significant number of patients need hospitalization and receive intensive health care. A proportion of hospitalized patients will need intubation. Tracheostomy is performed as one of the potential treatment steps in the management of these patients for long-term ventilation, suction of respiratory secretions, etc. If hospitalized COVID-19 patients need tracheostomy after intubation, it will be challenging to plan an optimal timing for doing tracheostomy procedure. Knowing the effect of this timing on the clinical outcome of patients can help us with this decision making. Aim: To assess the timing of tracheostomy and its Impact on clinical outcome in Patients with Covid-19 admitted in ICU Materials and methods: Information about patients who were admitted to Imam Reza Hospital and underwent tracheostomy with positive PCR for COVID-19 was collected. Based on the time interval between intubation and tracheostomy, patients were divided into early and late groups. Some characteristics and clinical outcomes in the patients of these two groups were compared. R-4.3.1 software was used for statistical analysis. Results: The data of 62 patients were analysed. 14 patients underwent tracheostomy during the first 14 days after intubation and were classified as early group. 48 patients underwent tracheostomy after 14 days of intubation and were classified as late group. Early group patients were under mechanical ventilation for an average of 28.57 days and late group patients for an average of 30 days after tracheostomy. (p-value = 0.7) In total, early group patients were under mechanical ventilation for an average of 39.36 days and late group patients for an average of 58.42 days. (p-value=0.06) the survival obtained in the early group was 57.1% and in the late group was 39.6%. (p-value = 0.39)