Comparison of outcomes between early and late tracheotomy

Introduction: The timing of tracheostomy in ventilated patients remains controversial. This study aimed to compare the effect of early tracheostomy (≤7 days) with late tracheotomy (>7 days) on the prognosis of patients requiring prolonged mechanical ventilation. Methods: This was a retrospective observational cohort study. The data of 175 subjects who received tracheotomy at the intensive care unit (ICU) between January 1, 2015, and July 31, 2022, were collected. Subjects were excluded from the study if medical records were incomplete or they underwent tracheotomy as part of a planned operation procedure. One-to-one propensity score matching was used to correct the baseline characteristics between the early and late tracheostomy groups. The treatment process and outcomes were compared between the two groups. The primary outcome was the incidence of ventilator-associated pneumonia (VAP) between the two groups. Results: After propensity score matching, 88 subjects were included in the analysis. Compared with the late tracheotomy group, the incidence of VAP, hospital length of stay, and sedation-free days, ventilator-free days, and ICU-free days were longer in the early tracheotomy group. There were no significant differences in the 90-day mortality between the two groups. Conclusions: Early tracheostomy can reduce the occurrence of complications for ICU patients.