Early tracheostomy after cardiac surgery improves intermediate- and long-term survival

Area of Science:

• Cardiology
• Thoracic Surgery
• Critical Care Medicine

Background:

• Complicated post-cardiac surgery courses often necessitate prolonged ICU stays and mechanical ventilation, sometimes requiring tracheostomy.
• Tracheostomy timing is a critical factor influencing outcomes in these complex patients.

Purpose of the Study:

• To evaluate the impact of tracheostomy timing on early, intermediate, and late mortality after cardiac surgery.
• To assess the incidence of superficial and deep sternal wound infections in relation to tracheostomy timing.

Main Methods:

• Retrospective analysis of prospectively collected data from a tertiary hospital.
• Patients were categorized into early (4-10 days), intermediate (11-20 days), and late (≥21 days) tracheostomy groups.
• Primary outcomes included mortality rates; secondary outcome was sternal wound infection incidence.

Main Results:

• Out of 12,782 cardiac surgery patients, 407 (3.18%) required tracheostomy.
• Early and intermediate tracheostomy groups showed significantly lower 1- and 5-year mortality compared to the late group (P < .001).
• Cox regression identified age and tracheostomy timing as significant predictors of mortality.

Conclusions:

• The timing of tracheostomy following cardiac surgery significantly impacts patient survival.
• Early tracheostomy, performed within 4-10 days of mechanical ventilation, is associated with improved intermediate and long-term survival outcomes.