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Observational Study
. 2021 Jun;131(6):E1797-E1804.
doi: 10.1002/lary.29391. Epub 2021 Jan 27.

Tracheotomy Outcomes in 64 Ventilated COVID-19 Patients at a High-Volume Center in Bronx, NY

Yasmina Ahmed  1 , Angela Cao  1 , Arielle Thal  1 , Sharan Shah  1 , Corin Kinkhabwala  1 , David Liao  1 , Daniel Li  1 , Michael Parides  2 , Vikas Mehta  1 , Thomas Ow  1 , Richard Smith  1 , Bradley A Schiff  1
Affiliations
Observational Study

Tracheotomy Outcomes in 64 Ventilated COVID-19 Patients at a High-Volume Center in Bronx, NY

Yasmina Ahmed et al. Laryngoscope. 2021 Jun.

Abstract

Objectives/hypothesis: The COVID-19 pandemic has resulted in a dramatic increase in the number of patients requiring prolonged mechanical ventilation. Few studies have reported COVID-19 specific tracheotomy outcomes, and the optimal timing and patient selection criteria for tracheotomy remains undetermined. We delineate our outcomes for tracheotomies performed on COVID-19 patients during the peak of the pandemic at a major epicenter in the United States.

Methods: This is a retrospective observational cohort study. Mortality, ventilation liberation rate, complication rate, and decannulation rate were analyzed.

Results: Sixty-four patients with COVID-19 underwent tracheotomy between April 1, 2020 and May 19, 2020 at two tertiary care hospitals in Bronx, New York. The average duration of intubation prior to tracheotomy was 20 days ((interquartile range [IQR] 16.5-26.0). The mortality rate was 33% (n = 21), the ventilation liberation rate was 47% (n = 30), the decannulation rate was 28% (n = 18), and the complication rate was 19% (n = 12). Tracheotomies performed by Otolaryngology were associated with significantly improved survival (P < .05) with 60% of patients alive at the conclusion of the study compared to 9%, 12%, and 19% of patients undergoing tracheotomy performed by Critical Care, General Surgery, and Pulmonology, respectively.

Conclusions: So far, this is the second largest study describing tracheotomy outcomes in COVID-19 patients in the United States. Our early outcomes demonstrate successful ventilation liberation and decannulation in COVID-19 patients. Further inquiry is necessary to determine the optimal timing and identification of patient risk factors predictive of improved survival in COVID-19 patients undergoing tracheotomy.

Level of evidence: 4-retrospective cohort study Laryngoscope, 131:E1797-E1804, 2021.

Keywords: Tracheotomy; coronavirus; coronavirus disease 2019; severe acute respiratory syndrome coronavirus 2; tracheostomy outcomes.

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BIBLIOGRAPHY

    1. COVID-19 Map. Johns Hopkins Coronavirus Resource Center. Available at: https://coronavirus.jhu.edu/map.html. Accessed December 2, 2020.
    1. CDC. Coronavirus Disease 2019 (COVID-19) in the U.S. Centers for Disease Control and Prevention. Published March 28, 2020. Available at: https://www.cdc.gov/covid-data-tracker. Accessed December 2, 2020.
    1. Tay JK, Khoo ML-C, Loh WS. Surgical considerations for tracheostomy during the COVID-19 pandemic: lessons learned from the severe acute respiratory syndrome outbreak. JAMA Otolaryngol Head Neck Surg 2020;146:517-518. https://doi.org/10.1001/jamaoto.2020.0764.
    1. David AP, Russell MD, El-Sayed IH, Russell MS. Tracheostomy guidelines developed at a large academic medical center during the COVID-19 pandemic. Head Neck 2020;42:1291-1296. https://doi.org/10.1002/hed.26191.
    1. Guan W, Ni Z, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382:1708-1720. https://doi.org/10.1056/NEJMoa2002032.

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