Tracheostomy
Conditions
Keywords
Tracheostomy, Intensive care unit, Mechanical ventilation, Multidisciplinary decision-making, Point-prevalence study
Brief summary
The primary objective of this study was to determine the point-prevalence of tracheostomy in adult intensive care units (ICUs) in Izmir and to characterize the documented reasons for postponement of tracheostomy, with attention to family-related deferral. Secondary objectives included tracheostomy indications, techniques, complications, timing, the relationship between illness severity (APACHE II) and mortality, and short-term outcomes. This multicenter, descriptive point-prevalence study was conducted across eleven adult ICUs in six hospitals on September 8, 2025. Of 282 adult patients present on the index day, 46 had a tracheostomy and formed the analytic subgroup. The study aimed to provide observational data on how tracheostomy is managed in a real-world clinical setting, focusing on the decision-making process and clinical characteristics associated with patient mortality.
Detailed description
This investigation was designed as a multicentre, descriptive point-prevalence study. On the specified prevalence day, all patients aged ≥18 present on the prevalence day were screened; those with an established tracheostomy formed the analytic subgroup. The data collection process involved: * Documentation of ICU structural characteristics across eleven adult ICUs in six hospitals, including bed capacity and annual tracheostomy volumes. * Evaluation of the interval from endotracheal intubation to tracheostomy and identification of documented reasons for any delay. * Assessment of the association between APACHE II score and 30-day in-hospital mortality. * A 30-day follow-up to assess mortality outcomes and causes of death.
Interventions
PROCEDURETracheostomy
The application of surgical or percutaneous dilatational tracheostomy (Griggs guidewire dilating forceps or Ciaglia single-dilator techniques) for indications such as prolonged mechanical ventilation
Sponsors
Izmir City Hospital
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Aged 18 years and older * Present in a participating adult ICU on the point-prevalence day
Exclusion criteria
* Patients younger than 18 years
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 30-day in-hospital mortality from the index date | Up to 30 days after the index day | The proportion of patients who died within 30 days of the index (point-prevalence) date. Because tracheostomies were prevalent (established before the survey), this is a point-prevalence snapshot rather than a procedure-anchored rate. |
| Point-prevalence of tracheostomy and documented reasons for postponement | Day 1 | The proportion of adult ICU patients with a tracheostomy on the index day, and the distribution of documented reasons for postponement of tracheostomy (including family-related deferral). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Intubation-to-tracheostomy interval (days) | From endotracheal intubation to tracheostomy, assessed through Day 1 | Median days from endotracheal intubation to tracheostomy |
| Distribution of tracheostomy technique (surgical vs percutaneous) | Day 1 | Proportion of surgical versus percutaneous tracheostomies. |
| Early and late complication rates by technique | From tracheostomy through Day 1 | Proportion of patients with early and late complications, by technique. |
| APACHE II score and its discrimination for 30-day mortality | Up to 30 days after the index day | Discrimination (area under the ROC curve) of the admission APACHE II score for 30-day mortality. |
| Causes of death among non-survivors | Up to 30 days after the index day | Distribution of causes of death among non-survivors. |
Countries
Turkey (Türkiye)
Contacts
STUDY_DIRECTORMurat KAYKAC, M.D.
Izmir City Hospital
Outcome results
None listed