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. 2021 Jun 16;10(12):2651.
doi: 10.3390/jcm10122651.

Tracheostomy Timing and Outcome in Severe COVID-19: The WeanTrach Multicenter Study

Denise Battaglini  1   2 , Francesco Missale  3 , Irene Schiavetti  4 , Marta Filauro  3 , Francesca Iannuzzi  1   5 , Alessandro Ascoli  3 , Alberto Bertazzoli  6 , Federico Pascucci  6 , Salvatore Grasso  7 , Francesco Murgolo  7 , Simone Binda  8 , Davide Maraggia  8 , Giorgia Montrucchio  9 , Gabriele Sales  9 , Giuseppe Pascarella  10 , Felice Eugenio Agrò  10 , Gaia Faccio  11 , Sandra Ferraris  11 , Savino Spadaro  12 , Giulia Falò  12 , Nadia Mereto  13 , Alessandro Uva  13 , Jessica Giuseppina Maugeri  14 , Bellissima Agrippino  14 , Maria Vargas  15 , Giuseppe Servillo  15 , Chiara Robba  1   5 , Lorenzo Ball  1   5 , Francesco Mora  3 , Alessio Signori  4 , Antoni Torres  16 , Daniele Roberto Giacobbe  17   18 , Antonio Vena  18 , Matteo Bassetti  17   18 , Giorgio Peretti  3 , Patricia R M Rocco  19   20 , Paolo Pelosi  1   5
Affiliations

Tracheostomy Timing and Outcome in Severe COVID-19: The WeanTrach Multicenter Study

Denise Battaglini et al. J Clin Med. .

Abstract

Background: Tracheostomy can be performed safely in patients with coronavirus disease 2019 (COVID-19). However, little is known about the optimal timing, effects on outcome, and complications.

Methods: A multicenter, retrospective, observational study. This study included 153 tracheostomized COVID-19 patients from 11 intensive care units (ICUs). The primary endpoint was the median time to tracheostomy in critically ill COVID-19 patients. Secondary endpoints were survival rate, length of ICU stay, and post-tracheostomy complications, stratified by tracheostomy timing (early versus late) and technique (surgical versus percutaneous).

Results: The median time to tracheostomy was 15 (1-64) days. There was no significant difference in survival between critically ill COVID-19 patients who received tracheostomy before versus after day 15, nor between surgical and percutaneous techniques. ICU length of stay was shorter with early compared to late tracheostomy (p < 0.001) and percutaneous compared to surgical tracheostomy (p = 0.050). The rate of lower respiratory tract infections was higher with surgical versus percutaneous technique (p = 0.007).

Conclusions: Among critically ill patients with COVID-19, neither early nor percutaneous tracheostomy improved outcomes, but did shorten ICU stay. Infectious complications were less frequent with percutaneous than surgical tracheostomy.

Keywords: COVID-19; SARS-CoV-2; coronavirus; intensive care; percutaneous; surgical technique; tracheostomy.

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Conflict of interest statement

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Figures

Figure 1
Figure 1
Overall survival of critically ill COVID-19 patients after receiving tracheostomy before or after 15 days. Kaplan–Meier curve of cumulative probability of survival. Patients were grouped by the timing of tracheostomy: early or late (cut-off, 15 days).
Figure 2
Figure 2
Overall survival of critically ill COVID-19 patients after receiving percutaneous versus surgical tracheostomy. Kaplan–Meier curve of cumulative probability of survival in percutaneous versus surgical tracheostomy groups.
See this image and copyright information in PMC

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