Systematic Review Effect of Tracheostomy on Mortality Rate among COVID-19 Patients

Document Type

Article

Publication Title

JACS: Journal of the American College of Surgeons

Abstract

Introduction:

Tracheostomy is a procedure to open an airway passage that could decrease days of mechanical ventilation and risk of mortality among hospitalized COVID-19 patients. Tracheotomy is recommended to treat COVID-19 patients.

Methods:

This study is a systematic review of nine published research or case series articles. The search keywords are “Tracheostomy” and “COVID-19”. The after information is extracted from each study: 1) study design; 2) study population; 3) comparison group; 4) measurable outcomes; 5) key findings; 5). The articles are categorized by level of evidence: Level A - Systematic review or randomized controlled trial Level B - Non-randomized controlled trial Level C - Observational or case-controlled study Level D - Cross-sectional study Level E - Case report. The number needed to treat (NNT) is calculated if possible.

Results:

Nine articles are included in the study. 5 articles are observational studies. The NNT was calculated on four articles comparing tracheotomy vs control. The average NNT is 6.2 (±4.37). They are needed to treat 6.2 patients with a tracheostomy to prevent one death. One study reported that patients undergoing tracheotomy performed by an otolaryngologist are less likely to die than if a critical care physician, general surgeon, or pulmonologist performed the procedure.

Conclusion:

Most of the reviewed studies reported that tracheostomy benefits patients and reduces mortality risks. Even though these articles are not ranked in a high level of evidence, they gave us insightful information to help the healthcare providers to make decisions on how to treat COVID-19 patients.

DOI

10.1097/01.XCS.0000895936.90842.5a

Publication Date

11-2022

ISSN

1879-1190

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