Correlation between tracheostomy timing and length of stay in critically ill patients

Abstract

Background & objective: Tracheostomy is the most frequently performed operative procedure in the Intensive Care Unit (ICU). The most common indication for a tracheostomy is the need of prolonged mechanical ventilation (PMV). The benefits of tracheostomy over an endotracheal tube include the safer, more comfortable breathing support, better oral hygiene, less need for sedation, and faster weaning of mechanical ventilation. The most appropriate and optimal time to perform a tracheostomy procedure is still controversial. Therefore, we wanted to describe the relationship between tracheostomy timing and length of stay (LOS) in the ICU of Dr. Moewardi Hospital during 2019 - 2020.

Methodology: This study was an observational, analytical retrospective cohort study. We used consecutive sampling technique from 79 patients, based on inclusion and exclusion criteria. Tracheostomy timings were assigned into two groups; early tracheostomy (during first 8 days) and late tracheostomy groups (after 8 days) . To analyze the relationship between tracheostomy timing and LOS, chi-square test was performed.

Results: Of the 79 subjects, 52 samples were in early tracheostomy and 27 in late tracheostomy group. Chi-square test revealed a significant correlation between tracheostomy timing and length of stay (P = 0.000). Also, age, sex, did not correlate with LOS (P > 0.05). The only factor related to LOS significantly was severity with APACHE II score and initial indication of tracheostomy (P = 0.000). After making gradual adjustments to other variables that affect LOS, tracheostomy timing and APACHE II score, only tracheostomy timing had a significance value of 0.000 in the second stage of the multivariate analysis.

Conclusion: In conclusion, tracheostomy timing was significantly associated with LOS. Early tracheostomy significantly shortens length of hospitalization.

Keywords: Early Tracheostomy; Length of Stay; Intensive Care Unit.

Citation: Permana SA, Amelia A, Adithya B. Correlation between tracheostomy timing and length of stay in critically ill patients. Anaesth. pain intensive care 2024;28(6): 1004-1009; DOI: 10.35975/apic.v28i6.2620

Received: December 21, 2021; Reviewed: February 11, 2023; Accepted: February 12, 2023