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Observational Study
. 2021 May;278(5):1605-1612.
doi: 10.1007/s00405-020-06220-3. Epub 2020 Aug 4.

Outcome of 1890 tracheostomies for critical COVID-19 patients: a national cohort study in Spain

Cristina Martin-Villares  1   2 , Carmen Perez Molina-Ramirez  3 , Margarita Bartolome-Benito  4 , Manuel Bernal-Sprekelsen  5 ; COVID ORL ESP Collaborative Group (*)
Collaborators, Affiliations
Observational Study

Outcome of 1890 tracheostomies for critical COVID-19 patients: a national cohort study in Spain

Cristina Martin-Villares et al. Eur Arch Otorhinolaryngol. 2021 May.

Abstract

Background: The question of an optimal strategy and outcomes in COVID-19 tracheostomy has not been answered yet. The critical focus in our case study is to evaluate the outcomes of tracheostomy on intubated COVID-19 patients.

Methods: A multicentric prospective observational study of 1890 COVID-19 patients undergoing tracheostomy across 120 hospitals was conducted over 7 weeks in Spain (March 28 to May 15, 2020). Data were collected with an innovative approach: instant messaging via WhatsApp.

Outcome measurements: complications, achieved weaning and decannulation and survival.

Results: We performed 1,461 surgical (81.3%) and 429 percutaneous tracheostomies. Median timing of tracheostomy was 12 days (4-42 days) since orotracheal intubation. A close follow-up of 1616/1890 (85.5%) patients at the cut-off time of 1-month follow-up showed that in 842 (52.1%) patients, weaning was achieved, while 391 (24.2%) were still under mechanical ventilation and 383 (23.7%) patients had died from COVID-19. Decannulation among those in whom weaning was successful (n = 842) was achieved in 683 (81%) patients.

Conclusion: To the best of our knowledge, this is the largest cohort of COVID-19 patients undergoing tracheostomy. The critical focus is the unprecedented amount of tracheostomies: 1890 in 7 weeks. Weaning could be achieved in over half of the patients with follow-up. Almost one out of four tracheotomized patients died from COVID-19.

Keywords: COVID-19; Intensive care unit; Mechanical ventilation; Tracheostomy.

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Conflict of interest statement

We have no conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Cumulative COVID-19 tracheostomies performed by COVID ORL ESP Collaborative Group
Fig. 2
Fig. 2
Tracheostomies on COVID-19 patients per day
Fig. 3
Fig. 3
Distribution of tracheostomies in COVID-19 patients per hospital
Fig. 4
Fig. 4
Outcome of 1890 tracheostomies for critical COVID-19 patients in Spain
See this image and copyright information in PMC

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