About: Tracheostomy in COVID-19 - safety and 30-day outcomes of the first 100 cases from a single tertiary UK hospital: a prospective observational cohort study

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About: Tracheostomy in COVID-19 - safety and 30-day outcomes of the first 100 cases from a single tertiary UK hospital: a prospective observational cohort study Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Tracheostomy in COVID-19 - safety and 30-day outcomes of the first 100 cases from a single tertiary UK hospital: a prospective observational cohort study
Creator	Hospital, Queen Bangash, Mansoor Parekh, Dhruv Patel, Jaimin Richter, Alex »more»
source	Elsevier
abstract	Background The role of tracheostomy in COVID-19 is unclear, with several consensus guidelines advising against this practice. We developed both a dedicated airway team and coordinated education programme to facilitate ward management of tracheostomised COVID-19 patients. Here, we report outcomes in the first 100 COVID-19 patients that underwent tracheostomy at our institution. Methods This was a prospective observational cohort study of patients confirmed to have COVID-19 that required mechanical ventilation at Queen Elizabeth Hospital, Birmingham, UK. The primary outcome measure was 30-day survival, accounting for severe organ dysfunction [APACHE-II score>17]. Secondary outcomes included duration of ventilation, ICU stay and healthcare workers directly involved in tracheostomy care acquiring COVID-19. Results 164 COVID-19 patients were admitted to ICU between March 9th-April 21st 2020. 100 patients (mean (SD) age:55 (12); 29% female) underwent tracheostomy; 64 (age: 57 (14); 25% female) did not undergo tracheostomy. Despite similar APACHE-II scores, 30-day survival was higher in 85/100 (85%) patients after tracheostomy, compared with 27/64 (42%) non-tracheostomised patients (relative risk: 3.9 [95% confidence intervals (CI):2.3-6.4); p<0.0001]). In patients with APACHE-II scores ≥17, 68/100 (68%) tracheotomised patients survived, compared with 12/64 (19%) non-tracheotomised patients (p<0.001). Tracheostomy within 14 days of intubation was associated with shorter duration of ventilation (mean difference:6.0 days [95%CI:3.1-9.0; p<0.0001] and ICU stay (mean difference:6.7 days [95% CI:3.7-9.6; p<0.0001). No healthcare workers developed COVID-19. Conclusion Independent of the severity of critical illness from COVID-19, 30-day survival was higher, and ICU stay shorter, in patients receiving tracheostomy. Early tracheostomy appears to be safe in COVID-19.
has issue date	2020-08-28(xsd:dateTime)
bibo:doi	10.1016/j.bja.2020.08.023
has license	els-covid
sha1sum (hex)	01fe6e2609e4315bb1f5881c54d87f7243928c74
schema:url	https://doi.org/10.1016/j.bja.2020.08.023
resource representing a document's title	Tracheostomy in COVID-19 - safety and 30-day outcomes of the first 100 cases from a single tertiary UK hospital: a prospective observational cohort study
resource representing a document's body	covid:01fe6e2609e4315bb1f5881c54d87f7243928c74#body_text
is schema:about of	named entity 'coordinated' named entity 'cohort study' named entity 'Journal' named entity 'AIRWAY' named entity 'PROGRAMME' »more»

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