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Evaluating tracheostomy techniques in severe coronavirus disease 2019: open vs. percutaneous approaches

Published online by Cambridge University Press:  04 April 2025

Dean G. Kennedy Open the ORCID record for Dean G. Kennedy [Opens in a new window] ,
Nicholas Y. K. Chong Open the ORCID record for Nicholas Y. K. Chong [Opens in a new window] ,
Michelle T. Wiegn ,
Jonathan M. Carnino  and
Jessica R. Levi
Dean G. Kennedy*
Affiliation:
Boston University School of Medicine, Boston, MA, USA
Nicholas Y. K. Chong
Affiliation:
Boston University School of Medicine, Boston, MA, USA
Michelle T. Wiegn
Affiliation:
Boston University, Boston, MA, USA
Jonathan M. Carnino
Affiliation:
Boston University School of Medicine, Boston, MA, USA
Jessica R. Levi
Affiliation:
Department of Otolaryngology – Head and Neck Surgery and Pediatrics, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
*
Corresponding author: Dean Kennedy; Email: dgkenn@bu.edu
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Abstract

Objectives

This study compares outcomes of open versus percutaneous tracheostomies in coronavirus disease 2019 patients to guide clinical decision-making based on disease severity.

Methods

A retrospective cohort study using the 2020 National Readmissions Database identified 4810 coronavirus disease 2019 patients (International Statistical Classification of Diseases and Related Health Problems 10th Revision code U071) who underwent tracheostomy. Of these, 2061 had open and 2749 had percutaneous tracheostomies. Patient demographics, severity (All Patient Refined-Diagnosis Related Groups) and outcomes (mortality, readmission, complications) were analysed using chi-squared tests, both overall and by severity.

Results

Mortality was higher in the percutaneous group (29.25 per cent) compared to the open group (26.35 per cent) (p = 0.0265). For severe cases (All Patient Refined-Diagnosis Related Groups 3–4), open tracheostomies had significantly lower mortality, readmission and complication rates (p < 0.05).

Conclusion

Open tracheostomies are associated with better outcomes in severe coronavirus disease 2019 cases. Percutaneous tracheostomies are effective in mild cases, but patient selection and procedural planning should consider disease severity. Future research should validate these findings.

Keywords

Covid-19TracheostomyOutcome AssessmentOtorhinolaryngologyHospital MortalityPatient ReadmissionSeverity of Illness Index

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , First View , pp. 1 - 3
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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