Open AccessTracheostomy Outcomes in Patients With COVID‐19 at a New York City Hospital
Author(s) -
Sharma Rahul K.,
Grewal Maeher R.,
Long Sallie M.,
DiDonna Brendon,
Sturm Joshua,
Hills Susannah E.,
Troob Scott H.
Publication year - 2022
Publication title -
oto open
Language(s) - English
Resource type - Journals
ISSN - 2473-974X
DOI - 10.1177/2473974x221101025
Subject(s) - covid-19 , medicine , emergency medicine , pandemic , betacoronavirus , medical emergency , intensive care medicine , history , virology , outbreak , disease , infectious disease (medical specialty)
Objective Tracheostomies have been performed in patients with prolonged intubation due to COVID‐19. Understanding outcomes in different populations is crucial to tackle future epidemics. Study Design Prospective cohort study. Setting Tertiary academic medical center in New York City. Methods A prospectively collected database of patients with COVID‐19 undergoing open tracheostomy between March 2020 and April 2020 was reviewed. Primary endpoints were weaning from the ventilator and from sedation and time to decannulation. Results Sixty‐six patients underwent tracheostomy. There were 42 males (64%) with an average age of 62 years (range, 23‐91). Patients were intubated for a median time of 26 days prior to tracheostomy (interquartile range [IQR], 23‐30). The median time to weaning from ventilatory support after tracheostomy was 18 days (IQR, 10‐29). Of those sedated at the time of tracheostomy, the median time to discontinuation of sedation was 5 days (IQR, 3‐9). Of patients who survived, 39 (69%) were decannulated. Of those decannulated before discharge (n = 39), the median time to decannulation was 36 days (IQR, 27‐49) following tracheostomy. The median time from ventilator liberation to decannulation was 14 days (IQR, 8‐22). Thirteen patients (20.0%) had minor bleeding requiring packing. Two patients (3%) had bleeding requiring neck exploration. The all‐cause mortality rate was 10.6%. No patients died of procedural causes, and no surgeons acquired COVID‐19. Conclusion Open tracheostomies were successfully and safely performed at our institution in the peak of the COVID‐19 pandemic. The majority of patients were successfully weaned from the ventilator and sedation. Approximately 60% of patients were decannulated prior to hospital discharge.