Respiratory failure & ventilation
Frequency and outcomes of critically ill COVID‐19 patients with tracheostomy, a retrospective two‐center cohort study
Authors' conclusion
Tracheostomy is common in critically ill COVID-19 patients. In patients predicted to need a tracheostomy at some point, early, rather than late, tracheostomy might be a means to reduce the time spent in ICU.
Study context
- Population
- Mechanically ventilated COVID-19-positive patients ≥18 years with respiratory failure admitted to critical care, Region Östergötland, Sweden, March 2020–September 2021intubated
- Participants
- 249 participants
- Exposure
- Early vs late tracheostomy
- Earlyn = 99
- Outcome
- Frequency and timing of tracheostomy
Methodological detailstwo-centre
- Two-centre
Main finding
As reported in the abstract
Underwent tracheostomy (of 249 intubated)
145
58%
Tracheostomies performed early
99
68%
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| ICU discharge rate | 0.59 (0.40–0.86) | P = 0.006 | |
| Ventilator weaning rate | 0.64 (0.12–3.32) | P = 0.5 | |
| 60-day mortality | 1.27 (0.61–2.67) | P = 0.5 | |
| 0.10.31310Adjusted hazard ratio (log scale) |
| Outcome | Early | Late | P value |
|---|---|---|---|
| IMV-free days, tracheostomy vs non-tracheostomy | P < 0.001 | ||
| ICU-free days, tracheostomy vs non-tracheostomy | P < 0.001 | ||
| IMV-free days | 36 (range 0–47) | 16 (range 0–31) | P < 0.001 |
| ICU-free days | 32 (range 0–44) | 8 (range 0–28) | P < 0.001 |
- Invasive mechanical ventilation (IMV)-free days, tracheostomy vs non-tracheostomy: Tracheostomy 27 (range 0–43)
- IMV-free days, tracheostomy vs non-tracheostomy: Non-tracheostomy 52 (range 43–55)
- Intensive care unit (ICU)-free days, tracheostomy vs non-tracheostomy: Tracheostomy 24 (range 0–40)
- ICU-free days, tracheostomy vs non-tracheostomy: Non-tracheostomy 49 (range 41–52)
Original publication
Frequency and outcomes of critically ill COVID‐19 patients with tracheostomy, a retrospective two‐center cohort study. Acta Anaesthesiol Scand. Published 18 March 2025. doi:10.
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