Outcomes of tracheostomy in COVID-19 patients in National Guard Health Affairs, Riyadh, Saudi Arabia

Abstract

Objectives: To evaluate coronavirus disease 2019 (COVID-19) patient tracheostomy outcomes. Methods: All COVID-19 patients at the National Guard Hospital, Riyadh, Saudi Arabia, were retrospectively recruited. Those who had tracheostomies between April and December 2020 were included. Results: The population was 45 patients, of which 30 (66.7%) were males, 15 (33.3%) were females and the mean age was 66.76±12.74 years. The tracheostomy indications were anticipated prolonged weaning in 40 (88.9%) and failed extubation in 5 (11.1%) of the patients. The mean intubation to tracheostomy duration was 20.62±7.21 days. Mortalities were high, with most attributed to COVID-19. Mortality and a pre-tracheostomy C-reactive protein (CRP) uptrend were significantly related ( p =0.039). Mortality and intubation to tracheostomy duration were not significantly related. The mean post-tracheostomy time to death was 10.64±6.9 days. Among the survivors, 20 (44.4%) males and 11 (24.4%) females were weaned off mechanical ventilation; 9 (20%) remained on ventilation during the study. The mean ventilation weaning time was 27.92±20 days. Conclusion: The high mortality rate was attributed to COVID-19. Mortality and a pre-tracheostomy CRP uptrend were significantly related; uptrend patients experienced far more mortalities than downtrend patients. Unlike previous findings, mortality and intubation to tracheostomy duration were not significantly related.

Characteristics and factors associated with mortality in tracheostomized patients with COVID-19: a retrospective cohort study in a hospital in Tacna, Peru

“…So far, the factors related to mortality in critically ill patients tracheostomized due to COVID-19 are the following: high values of C-reactive protein (CRP) at the time of tracheostomy 10 , higher inspired oxygen fraction (FiO 2 ) requirement 11 and early timing of tracheostomy 12 . Unfortunately, most of this information comes from developed countries and does not reflect the reality of Peru, a country with a fragile health system.…”

“…Hasta el momento los factores relacionados a la mortalidad en los pacientes críticamente enfermos traqueostomizados por COVID-19, son el nivel de proteína C reactiva (PCR) elevado en el momento de la traqueostomia 10 , mayor requerimiento de fracción inspirada de oxígeno (FiO 2 ) 11 y el momento temprano de realización 12 . Lamentablemente, la mayoría de esta información proviene de países desarrollados, y no refleja la realidad de Perú, país que tiene un frágil sistema de salud.…”