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Outcome of 1890 tracheostomies for critical COVID-19 patients: a national cohort study in Spain

BACKGROUND: The question of an optimal strategy and outcomes in COVID-19 tracheostomy has not been answered yet. The critical focus in our case study is to evaluate the outcomes of tracheostomy on intubated COVID-19 patients. METHODS: A multicentric prospective observational study of 1890 COVID-19 p...

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Autores principales: Martin-Villares, Cristina, Perez Molina-Ramirez, Carmen, Bartolome-Benito, Margarita, Bernal-Sprekelsen, Manuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7399582/
https://www.ncbi.nlm.nih.gov/pubmed/32749607
http://dx.doi.org/10.1007/s00405-020-06220-3
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author Martin-Villares, Cristina
Perez Molina-Ramirez, Carmen
Bartolome-Benito, Margarita
Bernal-Sprekelsen, Manuel
author_facet Martin-Villares, Cristina
Perez Molina-Ramirez, Carmen
Bartolome-Benito, Margarita
Bernal-Sprekelsen, Manuel
author_sort Martin-Villares, Cristina
collection PubMed
description BACKGROUND: The question of an optimal strategy and outcomes in COVID-19 tracheostomy has not been answered yet. The critical focus in our case study is to evaluate the outcomes of tracheostomy on intubated COVID-19 patients. METHODS: A multicentric prospective observational study of 1890 COVID-19 patients undergoing tracheostomy across 120 hospitals was conducted over 7 weeks in Spain (March 28 to May 15, 2020). Data were collected with an innovative approach: instant messaging via WhatsApp. Outcome measurements: complications, achieved weaning and decannulation and survival. RESULTS: We performed 1,461 surgical (81.3%) and 429 percutaneous tracheostomies. Median timing of tracheostomy was 12 days (4–42 days) since orotracheal intubation. A close follow-up of 1616/1890 (85.5%) patients at the cut-off time of 1-month follow-up showed that in 842 (52.1%) patients, weaning was achieved, while 391 (24.2%) were still under mechanical ventilation and 383 (23.7%) patients had died from COVID-19. Decannulation among those in whom weaning was successful (n = 842) was achieved in 683 (81%) patients. CONCLUSION: To the best of our knowledge, this is the largest cohort of COVID-19 patients undergoing tracheostomy. The critical focus is the unprecedented amount of tracheostomies: 1890 in 7 weeks. Weaning could be achieved in over half of the patients with follow-up. Almost one out of four tracheotomized patients died from COVID-19.
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spelling pubmed-73995822020-08-04 Outcome of 1890 tracheostomies for critical COVID-19 patients: a national cohort study in Spain Martin-Villares, Cristina Perez Molina-Ramirez, Carmen Bartolome-Benito, Margarita Bernal-Sprekelsen, Manuel Eur Arch Otorhinolaryngol Head and Neck BACKGROUND: The question of an optimal strategy and outcomes in COVID-19 tracheostomy has not been answered yet. The critical focus in our case study is to evaluate the outcomes of tracheostomy on intubated COVID-19 patients. METHODS: A multicentric prospective observational study of 1890 COVID-19 patients undergoing tracheostomy across 120 hospitals was conducted over 7 weeks in Spain (March 28 to May 15, 2020). Data were collected with an innovative approach: instant messaging via WhatsApp. Outcome measurements: complications, achieved weaning and decannulation and survival. RESULTS: We performed 1,461 surgical (81.3%) and 429 percutaneous tracheostomies. Median timing of tracheostomy was 12 days (4–42 days) since orotracheal intubation. A close follow-up of 1616/1890 (85.5%) patients at the cut-off time of 1-month follow-up showed that in 842 (52.1%) patients, weaning was achieved, while 391 (24.2%) were still under mechanical ventilation and 383 (23.7%) patients had died from COVID-19. Decannulation among those in whom weaning was successful (n = 842) was achieved in 683 (81%) patients. CONCLUSION: To the best of our knowledge, this is the largest cohort of COVID-19 patients undergoing tracheostomy. The critical focus is the unprecedented amount of tracheostomies: 1890 in 7 weeks. Weaning could be achieved in over half of the patients with follow-up. Almost one out of four tracheotomized patients died from COVID-19. Springer Berlin Heidelberg 2020-08-04 2021 /pmc/articles/PMC7399582/ /pubmed/32749607 http://dx.doi.org/10.1007/s00405-020-06220-3 Text en © Springer-Verlag GmbH Germany, part of Springer Nature 2020 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Head and Neck
Martin-Villares, Cristina
Perez Molina-Ramirez, Carmen
Bartolome-Benito, Margarita
Bernal-Sprekelsen, Manuel
Outcome of 1890 tracheostomies for critical COVID-19 patients: a national cohort study in Spain
title Outcome of 1890 tracheostomies for critical COVID-19 patients: a national cohort study in Spain
title_full Outcome of 1890 tracheostomies for critical COVID-19 patients: a national cohort study in Spain
title_fullStr Outcome of 1890 tracheostomies for critical COVID-19 patients: a national cohort study in Spain
title_full_unstemmed Outcome of 1890 tracheostomies for critical COVID-19 patients: a national cohort study in Spain
title_short Outcome of 1890 tracheostomies for critical COVID-19 patients: a national cohort study in Spain
title_sort outcome of 1890 tracheostomies for critical covid-19 patients: a national cohort study in spain
topic Head and Neck
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7399582/
https://www.ncbi.nlm.nih.gov/pubmed/32749607
http://dx.doi.org/10.1007/s00405-020-06220-3
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