Association Between Tracheostomy Timing and Clinical Outcomes in Critically Ill COVID ۱۹ Patients

Introduction:The COVID‑۱۹ pandemic has posed one of the greatest challenges to healthcare systems worldwide. Tracheostomy is often required in critically ill patients with COVID‑۱۹ who require prolonged mechanical ventilation and frequent airway clearance. Determining the optimal timing of tracheostomy in these patients, particularly after endotracheal intubation, remains clinically complex and controversial.Materials and Methods:This retrospective study included COVID‑۱۹–positive patients (confirmed by PCR) admitted to a referral hospital in Northwest Iran who underwent tracheostomy during their ICU stay. Patients were stratified into early and late tracheostomy groups based on the interval between intubation and tracheostomy (<۱۴ days vs. ≥۱۴ days). Demographic data, duration of mechanical ventilation before and after tracheostomy, and survival rates were analyzed.Results:A total of ۶۲ patients were evaluated. Fourteen patients (۲۲.۶%) underwent early tracheostomy, while forty‑eight patients (۷۷.۴%) underwent late tracheostomy. The mean duration of mechanical ventilation after tracheostomy was ۲۸.۵۷ days in the early group and ۳۰ days in the late group. The overall duration of mechanical ventilation was significantly shorter in the early group compared with the late group (۳۹.۳۶ vs. ۵۸.۴۲ days). Survival rates were ۵۷.۱% in the early group and ۳۹.۶% in the late group.Conclusion:Early tracheostomy-performed within the first ۱۴ days following intubation-significantly decreases the total duration of mechanical ventilation in critically ill COVID‑۱۹ patients. However, tracheostomy timing does not influence the duration of ventilation after tracheostomy or overall patient survival.

کلیدواژه ها:

COVID ۱۹ ، Tracheostomy ، Intubation ، Mechanical Ventilation ، Intensive Care Unit