Letters in High Energy Physics (Feb 2024)
The Effects of Surgical Tracheostomy Delays on Intensive Care Unit Patients in King Abdullah Medical City
Abstract
Background-Tracheostomy is a surgical procedure that offers several benefits for patients in the intensive care unit (ICU), such as preventing damage to the mouth and larynx, reducing airway resistance, lowering the risk of ventilator-associated pneumonia (VAP), enhancing patient comfort, reducing the need for sedatives, and improving mobility and the ability to eat orally. The timing of tracheostomy in severely ill patients on mechanical ventilation (MV) is a subject of debate. Delays in performing tracheostomy can result in significant hospital costs and may negatively affect patient outcomes. While clinical conditions primarily influence these delays, administrative and interdisciplinary factors may also contribute. Aim-To evaluate the impact of delaying surgical tracheostomy on ICU patients, particularly when bedside percutaneous tracheostomy is contentious, and to determine the benefits of early tracheostomy in improving patient outcomes and resource utilization in the ICU. Methods-This retrospective study analyzed data from 48 ICU patients to evaluate various factors affecting the timing and outcomes of tracheostomy. Results-Among the 48 ICU patients studied, 39.7% were aged 53-58 years, and gender distribution was equal. The APACHE II score indicated that 27.1% had a severity of illness score of 19, while the SOFA score showed that 52.1% had a score of seven for organ failure progression. There was an equal distribution of patients with and without prior ventilation. Regarding the type of tracheostomy, 52.1% were percutaneous, with the remainder being surgical. Primary diagnoses included 27.1% with post-cardiac arrest and 4.2% with acute respiratory failure. Primary medical conditions necessitating ICU admission were 14.6% with hypertension and 8.3% with COPD. Among secondary comorbid conditions, 12.5% had heart failure and 6.3% had obesity. The data also revealed that 12.5% of patients were on mechanical ventilation for 19 days before tracheostomy, aligning with the typical period of 14-21 days for critically ill patients. Conclusion-This research investigated the impact of delayed surgical tracheostomy on ICU patient outcomes, including length of stay, mortality, and complications. Despite study limitations, strong correlations were found, highlighting the importance of timely tracheostomy in critically ill patients. These findings and
