Impact of Tracheostomy on COVID-19 ICU Patients in Saudi Arabia: A Retrospective Analysis

Rawan A Alhazmi; Neeveen F Omer; Fatimah A Hameed; Sara Khan; Mohammed Khawajah; Hussain A Alabdullah; Tala O Althenayan; Amjad W Alhithlool; Ayman M Kharaba

doi:10.7759/cureus.52766

Impact of Tracheostomy on COVID-19 ICU Patients in Saudi Arabia: A Retrospective Analysis

Cureus. 2024 Jan 22;16(1):e52766. doi: 10.7759/cureus.52766. eCollection 2024 Jan.

Authors

Rawan A Alhazmi¹, Neeveen F Omer², Fatimah A Hameed², Sara Khan², Mohammed Khawajah², Hussain A Alabdullah³, Tala O Althenayan⁴, Amjad W Alhithlool³, Ayman M Kharaba⁵

Affiliations

¹ Medicine, Alrayan Medical Colleges, Madinah, SAU.
² Medicine, Fakeeh College for Medical Sciences, Jeddah, SAU.
³ College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU.
⁴ School of Medicine, Taibah University, Madinah, SAU.
⁵ Critical Care Medicine, King Fahad Hospital, Madinah, SAU.

Abstract

Introduction The COVID-19 pandemic has prompted the development of novel medical interventions, including tracheostomy, a surgical procedure for a direct airway. This study investigates the intricacies of managing critically ill patients in the ICU, focusing on its debated utility in the global crisis. Methods The study assessed the impact of tracheostomy on COVID-19 patients at Al-Ahsa Hospital, Saudi Arabia, using a retrospective cohort design and data from electronic health records and databases. It aimed to provide insights into treatment outcomes and practices. Results The findings of this study shed light on the significant impact of tracheostomy on the course of ICU treatment for COVID-19 patients. Total number of participants were 1389. The study cohort consisted of predominantly non-pregnant individuals with an average body mass index reflective of the regional population. Among the COVID-19 patients, only a small percentage, 63 (4.5%), required tracheostomy, while the majority, 1326 (95.5%), did not undergo this procedure. Analysis of ICU outcomes revealed that a substantial proportion of patients, 223 (16.1%), achieved total cure, while the remaining patients did not. After a 28-day ICU stay, the majority of individuals, 1287 (92.7%), were discharged, while a smaller percentage remained in the ICU, with 77 (5.5%) still requiring mechanical ventilation. Notably, patients who underwent tracheostomy had a significantly longer ICU stay compared to those who did not, with an average of 59 days versus 19 days, respectively. Furthermore, the study found that tracheostomy did not significantly impact ICU discharge outcomes, including death, discharge home, and transfer to another facility. However, it did influence hospital discharge outcomes, with lower mortality rates and a higher rate of transfer to another facility among patients who underwent tracheostomy. These results provide valuable insights into the management and outcomes of critically ill COVID-19 patients in the ICU, particularly in relation to the use of tracheostomy as a treatment intervention. Conclusion The study highlights the dual benefits of tracheostomy in COVID-19 care, extending hospital stays but not increasing ICU discharge rates, emphasizing the need for tailored clinical strategies.

Keywords: clinical practice implications; covid-19 icu tracheostomy; critical care strategies; future research directions; patient demographics analysis; regional healthcare variability; respiratory failure management; retrospective cohort study; saudi arabian healthcare; tracheostomy outcomes.