EARLY TRACHEOSTOMY MIGHT DECREASE THE DURATION OF HOSPITALIZATION AMONG ICU PATIENTS

T SARWAR; R PERVAIZ; S AKASH; HMH ARIF; AM ABDELBAKY; AHA AWAD; S BANO; S RAZA

doi:10.54112/pjicm.v4i01.23

Authors

T SARWAR Department of Internal and Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan
R PERVAIZ Department of Internal and Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan
S AKASH Department of Internal and Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan
HMH ARIF Department of Internal and Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan
AM ABDELBAKY Medical Intensive Care Unit, Rashid Hospital, Dubai Health, Dubai, UAE.
AHA AWAD Medical Intensive Care Unit, Rashid Hospital, Dubai Health, Dubai, UAE.
S BANO Department of Internal and Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan
S RAZA Department of Internal and Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v4i01.23

Keywords:

Tracheostomy, Mechanical Ventilation, Intensive Care Units, Critical Illness, Patient Outcomes

Abstract

Background: Prolonged invasive mechanical ventilation in critically ill patients can result in adverse outcomes, prompting consideration of tracheostomy (TQT) as a potential intervention. However, the optimal timing for TQT remains uncertain, necessitating further investigation into the clinical characteristics of patients undergoing early versus late TQT. Objectives: To compare outcomes, including duration of mechanical ventilation, ICU and hospital stays, and mortality rates, between patients undergoing early TQT (within approximately ten days of oro-tracheal intubation) and those undergoing late TQT (after ten days). Study Design: This study utilised a retrospective cohort design. Setting: Data were collected from patients admitted to Bahria International Hospital's ICU. Duration of Study: Data collection occurred between January 2022 and December 2023. Material and Methods: Patients were stratified based on the timing of TQT placement, and clinical outcomes were analysed accordingly. Parameters assessed included duration of mechanical ventilation, ICU and hospital stays, and mortality rates. Results: Patients in the early TQT group demonstrated shorter ICU and hospital stays (20 ± 17 vs. 33 ± 23 days, p = 0.03; 43 ± 33 vs. 53 ± 49 days, p = 0.01, respectively), reduced duration of mechanical ventilation (18 ± 15 vs. 31 ± 19 days, p < 0.001), and a higher ICU survival rate (64% vs. 55%). Conclusion: Early tracheostomy placement, performed within ten days of mechanical ventilation initiation, appears to confer benefits in shorter ICU and hospital stays, reduced mechanical ventilation duration, and improved ICU survival rates. These findings highlight the importance of timely TQT placement in critical care management strategies.

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