Comparing the Outcomes of Tracheostomy in COVID-19 and Non-COVID-19 Patients

Abstract

Objective: To assess and compare tracheostomy outcomes between COVID-19 patients and non-COVID-19 patients. Materials and Methods: This retrospective and prospective cohort study included patients over 18 years of age who underwent tracheostomy at a tertiary care hospital. We divided patients into 2 groups: 41 with COVID-19 and 156 without COVID-19. Primary outcomes were successful tracheostomy tube downsizing and removal, ventilator weaning, length of hospital stay, and mortality rate. Statistical analyses compared outcomes between groups. Results: COVID-19 patients achieved higher rates of successful tracheostomy tube downsizing (54.2% vs 9.6%, P < .001) and removal (36.6% vs 7.1%, P = .05) than non-COVID-19 patients. Mortality was lower in COVID-19 patients (29.3% vs 40.4%), although ventilator liberation rates were similar (P = .346). COVID-19 patients had longer hospital stays (64 vs 56 days); however, this difference was not statistically significant. We observed no significant differences in postoperative or long-term complications between groups. COVID-19 infection and age ≤60 years were factors associated with accelerated decannulation. COVID-19 patients demonstrated significantly higher rates of invasive pulmonary aspergillosis (P < .001). Conclusions: Despite lower mortality, COVID-19 patients achieved higher rates of tracheostomy tube downsizing and decannulation than non-COVID-19 patients. Ventilator liberation, hospital stay duration, and complication rates remained similar between groups.