Percutaneous tracheostomy procedures and patient results in a tertiary intensive care unit: A single-center...

The ideal timing for tracheostomy in patients undergoing prolonged mechanical ventilation (MV) in the intensive care unit (ICU) remains controversial. The present study aimed to provide an overview of the timing of percutaneous dilation tracheostomy performed in the ICU over a 5-year period, and the effect of this procedure on 28-day mortality. The study included patients who underwent early (≤14 days) (n = 112) and late (>14 days) (n = 171) tracheostomy during their follow-up in the ICU between 2018 and 2023. It is a single-center retrospective study. The diagnoses, comorbidities, MV duration, tracheostomy timing, tracheostomy indications, tracheostomy complications, ICU length of stay, hospital length of stay, extubation attempts, mortality, time to decannulation, and ICU discharge location were determined in both tracheostomy groups and compared. The effect of tracheostomy timing on mortality risk was evaluated using multivariate Cox regression analyses. In the early tracheostomy group, MV duration, ICU hospitalization, hospital stay, and extubation attempt were lower. The 28-day intensive care mortality rates were not statistically different between the early and late tracheostomy groups. Multivariate regression analysis showed that mortality risk increased with prolonged MV and tracheostomy complications. In terms of mortality rates in palliative care, mortality in the late tracheostomy group was significantly lower than in the early tracheostomy group. The study demonstrated that the timing of tracheostomy in the ICU had no effect on mortality risk in multivariate analysis. We believe that time is not the only limiting factor when considering tracheostomy and prospective randomized studies are needed.