Outcomes of COVID-19 Positive and COVID-19 Negative Adult Patients Who Underwent Tracheostomy for Prolonged Intubation in a COVID-19 Referral Center During the Pandemic

Authors

DOI:

https://doi.org/10.32412/pjohns.v38i1.2145

Keywords:

COVID-19, tracheostomy, prolonged mechanical ventilation, ventilatory weaning

Abstract

ABSTRACT

Objective: To compare outcomes of COVID-19 positive and COVID-19 negative patients who underwent tracheostomy for prolonged intubation in terms of weaning duration, length of ICU and hospital stay, overall and 30-day mortality, and explore risk factors for particular outcomes (mortality, 30-day mortality and weaning duration post tracheostomy).
Methods:

     Design: Retrospective Cohort Study
     Setting: Tertiary National University Hospital
     Participants: Of 122 adult patients that underwent tracheotomy between March 30, 2020 and March 30, 2021; 76 adult patients underwent tracheostomy for prolonged intubation were analyzed.
Results: Open tracheotomy was performed on 122 adult patients. Seventy six (62.3%) due to prolonged intubation and 46 (37.7%) for airway prophylaxis. Among the former, the mean age was 58.46±16.81 and 54 (71.05%) patients were female, 22 (28.95%) tested COVID-19 positive and 54 (71.05%) tested negative. Mean APACHE II score was 16.62±6.78. Average days of intubation prior to tracheostomy was 29.14±17.66 days. No statistically significant difference in outcomes (weaning days, length of stay, days discharge from ICU and hospital, 30-day mortality, days to death) were noted between COVID19 positive and negative patients who underwent tracheostomy for prolonged intubation. Mortality rates post tracheostomy in this institution appear to be higher than existing literature. On multiple linear regression analysis, days of intubation prior to tracheostomy was associated with increased weaning time post-tracheostomy (OR: 0.35 CI:0.18-0.51 95% p = <.001). This implies that for every additional day of intubation prior to tracheostomy, weaning days increase by 0.35 of a day.
Conclusion: Outcomes of COVID-19 compared to non-COVID-19 patients undergoing tracheostomy for prolonged intubation do not seem to be significantly different which is consistent with existing literature.

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Published

2023-06-04

How to Cite

1.
Yee E, Dela Cruz AP, Cruz TL, Villanueva CA, Cruz EJ. Outcomes of COVID-19 Positive and COVID-19 Negative Adult Patients Who Underwent Tracheostomy for Prolonged Intubation in a COVID-19 Referral Center During the Pandemic. Philipp J Otolaryngol Head Neck Surg [Internet]. 2023 Jun. 4 [cited 2024 Oct. 14];38(1):39. Available from: https://pjohns.pso-hns.org/index.php/pjohns/article/view/2145

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