OBJECTIVE: To examine the impact of early tracheotomy in nontrauma patients on duration of mechanical ventilation (MV), intensive care unit (ICU) stay, and overall hospital stay. DESIGN: Case series with chart review. SETTING: Tertiary care medical center. METHODS: A retrospective study was performed for patients undergoing tracheotomy from 2005 to 2010. Demographics; survival; duration of endotracheal intubation, MV, ICU, and overall hospital stay; and incidence of ventilator-associated pneumonia (VAP) were assessed. Tracheotomy was considered early if it was performed by day 7 of MV and late thereafter. Nonparametric statistics were used to compare results from each group. RESULTS: Of the 592 patients included in the analysis, 128 received tracheotomy early and 464 late. Differences between age, sex, and overall survival were not statistically significant. Duration of MV was 45% less (mean ± standard error: 21.47 ± 1.86 days vs 39.33 ± 1.33 days; P < .001), total ICU stay was shortened by 33% (17.52 ± 1.38 days vs 26.27 ± 0.73 days; P < .001), and length of overall hospital course was reduced by 34% (35.85 ± 2.57 days vs 54.28 ± 1.60 days; P < .001) in the early tracheotomy group. Three patients (2.3%) from the early tracheotomy group developed VAP as compared with 15 (3.2%) from the late group. Duration from tracheotomy to ICU transfer and 30% overall mortality did not differ significantly between groups. CONCLUSION: Early tracheotomy in ICU patients is associated with earlier ICU discharge, shorter duration of mechanical ventilation, and decreased length of overall hospital stay without affecting mortality.
OBJECTIVE: To examine the impact of early tracheotomy in nontrauma patients on duration of mechanical ventilation (MV), intensive care unit (ICU) stay, and overall hospital stay. DESIGN: Case series with chart review. SETTING: Tertiary care medical center. METHODS: A retrospective study was performed for patients undergoing tracheotomy from 2005 to 2010. Demographics; survival; duration of endotracheal intubation, MV, ICU, and overall hospital stay; and incidence of ventilator-associated pneumonia (VAP) were assessed. Tracheotomy was considered early if it was performed by day 7 of MV and late thereafter. Nonparametric statistics were used to compare results from each group. RESULTS: Of the 592 patients included in the analysis, 128 received tracheotomy early and 464 late. Differences between age, sex, and overall survival were not statistically significant. Duration of MV was 45% less (mean ± standard error: 21.47 ± 1.86 days vs 39.33 ± 1.33 days; P < .001), total ICU stay was shortened by 33% (17.52 ± 1.38 days vs 26.27 ± 0.73 days; P < .001), and length of overall hospital course was reduced by 34% (35.85 ± 2.57 days vs 54.28 ± 1.60 days; P < .001) in the early tracheotomy group. Three patients (2.3%) from the early tracheotomy group developed VAP as compared with 15 (3.2%) from the late group. Duration from tracheotomy to ICU transfer and 30% overall mortality did not differ significantly between groups. CONCLUSION: Early tracheotomy in ICU patients is associated with earlier ICU discharge, shorter duration of mechanical ventilation, and decreased length of overall hospital stay without affecting mortality.
Authors: Pelin Kocdor; Eric R Siegel; James Y Suen; Gresham Richter; Ozlem E Tulunay-Ugur Journal: Eur Arch Otorhinolaryngol Date: 2015-09-03 Impact factor: 2.503
Authors: Harish Dharmarajan; Michael A Belsky; Jennifer L Anderson; Shaum Sridharan Journal: Ann Otol Rhinol Laryngol Date: 2021-03-29 Impact factor: 1.547
Authors: Beatrice J Sun; Christopher J Wolff; Hannah M Bechtold; Dwayne Free; Javier Lorenzo; Patrick R Minot; Paul G Maggio; David A Spain; Thomas G Weiser; Joseph D Forrester Journal: Trauma Surg Acute Care Open Date: 2020-12-14