Association Between Timing of Percutaneous Dilatational Tracheotomyand Clinical Outcomes of Critically-ill Elderly Patients.

ABSTRACT

OBJECTIVE: To determine the effect of timing of tracheotomy on the outcome of critically-ill elderly patients. STUDY DESIGN: Descriptive study. Place and Duration of the Study Intensive Care Unit, Jingxian Hospital, Anhui, China, from January 2017 to December 2021. METHODOLOGY: Two hundred and thirty-five critically-ill elderly patients who had undergone percutaneous dilatational tracheotomy (PDT) were enrolled. The PDT-related complications and clinical outcomes were analysed. RESULTS: Overall, the PDT-related complications, including the amount of bleeding (6.1 ± 1.0 vs. 5.8 ± 0.9 vs. 5.8 ± 0.9, p<0.46) and wound infection [8(5.0%) vs. 2 (4.9%) vs. 3 (9.1%), p=0.62], showed no significant difference among the three groups. The length of ICU stay (13.3 ± 8.4 vs. 18.4 ± 17.8 vs. 24.1 ± 16.1 days, p<0.0001) in the very early PDT group was significantly shorter than that in the early and late PDT groups. The lowest hospital mortality rate [(59 (36.6%) vs. 28 (68.3%) vs. 15 (45.5%), p=0.0012)] was noted in the very early PDT group among the three groups, and a longer postoperative survival was recorded. CONCLUSION: A shortened length of ICU stay and a decreased hospital mortality were found in the very early PDT group, while a better postoperative survival rate was achieved. KEY WORDS Percutaneous dilatational tracheotomy, Mortality, Outcome, Timing, Intensive care unit.