Sociodemographic Disparities in Tracheostomy Timing and Outcomes.

Area of Science:

• Critical Care Medicine
• Surgical Outcomes
• Health Disparities

Background:

• Tracheostomy is crucial for prolonged mechanical ventilation in critically ill patients.
• Early tracheostomy is linked to better patient outcomes, but timing can be delayed due to complex factors.
• Sociodemographic variables may influence tracheostomy timing and subsequent patient outcomes.

Purpose of the Study:

• To investigate the impact of sociodemographic factors on tracheostomy timing.
• To analyze the association between tracheostomy timing and patient outcomes, including hospital length of stay and complications.

Main Methods:

• Retrospective review of medical records for adult, ventilator-dependent patients who underwent tracheostomy between 2021 and 2022.
• Categorization of tracheostomy timing into routine (<21 days) and late (≥21 days).
• Comparison of sociodemographic variables and outcomes (LOS, decannulation, complications, mortality) between cohorts using univariate and multivariate models.

Main Results:

• Late tracheostomy was performed in 25.4% of patients (n=36).
• Non-English speaking patients (OR 3.18) and women (OR 3.15) were significantly more likely to receive a late tracheostomy.
• Late tracheostomy was associated with a longer median hospital length of stay (62 vs. 52 days).

Conclusions:

• Non-English speaking and female patients face a higher likelihood of delayed tracheostomy, despite its association with increased hospital length of stay.
• Implementing standardized tracheostomy protocols could mitigate biases in timing and potentially reduce hospital resource utilization.