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

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has 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 Shields, Adrian Sharma, Neil Murphy, Nick Pracy, Paul Breik, Omar Dawson, Camilla Idle, Matthew Isherwood, Peter Jennings, Christopher Keene, Damian Manji, Mav Martin, Tim Moss, Rob Nankivell, Paul Parmar, Sat Praveen, Prav Richardson, Carla Sachdeva, Rajneesh Siddiq, Somiah Smart, Simon Tasker, Laura
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
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