Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Association Between Tracheostomy Timing and Clinical Outcomes in Critically Ill COVID 19 Patients

Document Type : Original

Authors
Nikzad Shahidi 1
Ata Mahmoudpour 2
Mehrdad Shahidi 3
Hesam Shahmohammadi 4
1 Department of Otorhinolaryngology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
2 Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
3 Department of Clinical Pharmacy, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.
4 Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
10.22038/ijorl.2025.86206.3941
Abstract
Introduction:
The COVID‑19 pandemic has posed one of the greatest challenges to healthcare systems worldwide. Tracheostomy is often required in critically ill patients with COVID‑19 who require prolonged mechanical ventilation and frequent airway clearance. Determining the optimal timing of tracheostomy in these patients, particularly after endotracheal intubation, remains clinically complex and controversial.
Materials and Methods:
This retrospective study included COVID‑19–positive patients (confirmed by PCR) admitted to a referral hospital in Northwest Iran who underwent tracheostomy during their ICU stay. Patients were stratified into early and late tracheostomy groups based on the interval between intubation and tracheostomy (<14 days vs. ≥14 days). Demographic data, duration of mechanical ventilation before and after tracheostomy, and survival rates were analyzed.
Results:
A total of 62 patients were evaluated. Fourteen patients (22.6%) underwent early tracheostomy, while forty‑eight patients (77.4%) underwent late tracheostomy. The mean duration of mechanical ventilation after tracheostomy was 28.57 days in the early group and 30 days in the late group. The overall duration of mechanical ventilation was significantly shorter in the early group compared with the late group (39.36 vs. 58.42 days). Survival rates were 57.1% in the early group and 39.6% in the late group.
Conclusion:
Early tracheostomy-performed within the first 14 days following intubation-significantly decreases the total duration of mechanical ventilation in critically ill COVID‑19 patients. However, tracheostomy timing does not influence the duration of ventilation after tracheostomy or overall patient survival.
Keywords
COVID 19
Tracheostomy
Intubation
Mechanical ventilation
Intensive care unit
Subjects
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Iranian Journal of Otorhinolaryngology
Volume 37, Issue 6
November and December 2025
Pages 311-319