Tracheostomy in Critically Ill Patients Due to COVID-19 Before the Vaccine, Cases and Controls<br /> <div> <br /> </div>

Abstract

Objective: This study aims to identify factors associated with death in seriously ill patients with SARS CoV-2 pneumonia who required a tracheostomy and the time in which the procedure was performed. Patients and methods: The study was observational, analytical, prospective, cross-sectional, and case-control in nature. The decision to perform a tracheostomy was based on the clinical conditions and the approval of the Institutional COVID Committee. To compare means of continuous numerical variables, paired and unpaired Student's t test was used depending on the variables analyzed; to establish correlation between continuous numerical variables, the Pearson correlation coefficient was calculated; to analyze the probability of death with respect to the variables studied, the odds ratio was calculated with a 95% compatibility interval. Results: a total of 47 severely ill patients with COVID-19, who were admitted to the Intensive Care Unit, and required a tracheostomy, 17 women and 30 men, underwent an open tracheostomy. The population was predominantly male, and blood type A+ was more common. Most of them had at least one of the following comorbidities: Diabetes, hypertension, obesity or smoke. Only 10 patients survived until the end of following. All tracheostomies were performed in the first days of the illness, even in the first seven days, except for one patient. All tracheostomies were performed openly, almost all within a conventional operating room and performed by General Surgeons; We have not had any early or late complications, although the risk of tracheal stenosis remains latent; none of the surgeons presented symptoms of the disease, although detection test were never applied to us. Conclusion: In this group of patients, diabetes, systemic arterial hypertension, obesity, blood type "A" and age over 65 years were associated with higher mortality, while no improvement was shown when tracheostomy was performed early, even the first 7 days.