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

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JACS: Journal of the American College of Surgeons



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.


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.


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.


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.



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