The Impact of Percutaneus Tracheotomy on Patients with COVID-19 ARDS' Mortality and Length of Stay in The Critical Care Unit

Abstract

Objective: The aim of this study was to investigate the effect of percutaneous tracheotomy on mortality and length of stay in the intensive care unit (ICU) for patients with COVID-19-associated acute respiratory distress syndrome (ARDS). Materials and Methods: This study included patients with coronavirus disease-19 (COVID-19-associated) acute respiratory distress syndrome who were treated with invasive mechanical ventilation in a pandemic intensive care unit. Patients admitted to the pandemic intensive care unit between March and July 2021 were retrospectively reviewed. Patients who underwent percutaneous tracheotomy and did not have a tracheotomy during the follow-up were statistically compared in terms of laboratory and clinical characteristics such as mortality and length of stay in the intensive care unit. Results: The study included 102 orotracheally intubated patients diagnosed with COVID-19 acute respiratory distress syndrome. The number of tracheotomized and not-tracheotomized patients was 34 and 68, respectively. The mean age of the patients was 60.39 +/- 14.10 years. The mean time to perform percutaneous tracheotomy was 7.94 +/- 6.11 days. There was no significant difference in mortality rate between the two groups (p=0.298). However, patients who underwent tracheotomy had a longer length of stay in the intensive care unit compared to those who did not (35.00 +/- 24.60 days vs 13.20 +/- 11.69 days, p<0.001). Conclusion: Our study found no statistically significant difference in mortality rate between the two groups in our study. Additionally, the length of stay in the intensive care unit was not better in tracheotomized patients. While tracheotomy has some advantages in other severe lung diseases, its effect on mortality in patients with severe lung disease associated with COVID-19 should be evaluated further in randomized controlled trials.