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Tuberculosis & Respiratory Diseases

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Vol.83 No.2
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Effect of Early Tracheostomy on Clinical Outcomes in Patients with Prolonged Acute Mechanical Ventilation: A Single-Center Study

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2020, v.83 no.2, pp.167-174
https://doi.org/10.4046/trd.2019.0082
Yewon Kang (Pusan National University)
Wanho Yoo (Pusan National University)
Youngwoong Kim (Pusan National University)
(Pusan National University)


Yewon, K. , Wanho, Y. , Youngwoong, K. , & (2020). Effect of Early Tracheostomy on Clinical Outcomes in Patients with Prolonged Acute Mechanical Ventilation: A Single-Center Study. Tuberculosis & Respiratory Diseases, 83(2), 167-174, https://doi.org/10.4046/trd.2019.0082
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Abstract

Background: The purpose of this study was to investigate the effect of early tracheostomy on clinical outcomes inpatients 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. Earlyand 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. Incomparison 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. 36,973USD, p<0.001). Conclusion: Early tracheostomy was associated with lower 90-day mortality, shorter ventilator length of stay and shorterlengths of stays in hospital and ICU, as well as lower hospital costs than late tracheostomy.

keywords
Tracheostomy, Mechanical Ventilation, Mortality

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