Evaluating tracheostomy techniques in severe coronavirus disease 2019: open vs. percutaneous approaches.

This study compares outcomes of open versus percutaneous tracheostomies in coronavirus disease 2019 patients to guide clinical decision-making based on disease severity.A retrospective cohort study using the 2020 National Readmissions Database identified 4810 coronavirus disease 2019 patients (International Statistical Classification of Diseases and Related Health Problems 10th Revision code U071) who underwent tracheostomy. Of these, 2061 had open and 2749 had percutaneous tracheostomies. Patient demographics, severity (All Patient Refined-Diagnosis Related Groups) and outcomes (mortality, readmission, complications) were analysed using chi-squared tests, both overall and by severity.Mortality was higher in the percutaneous group (29.25 per cent) compared to the open group (26.35 per cent) (p = 0.0265). For severe cases (All Patient Refined-Diagnosis Related Groups 3-4), open tracheostomies had significantly lower mortality, readmission and complication rates (p < 0.05).Open tracheostomies are associated with better outcomes in severe coronavirus disease 2019 cases. Percutaneous tracheostomies are effective in mild cases, but patient selection and procedural planning should consider disease severity. Future research should validate these findings.

Duke Scholars

Author Jonathan Carnino