Association of Early Tracheostomy with Length of Stay and Mortality in Critically Ill Patients

Background: The timing of tracheostomy for intensive care unit (ICU) patients is controversial, with conflicting findings on early versus late tracheostomy. Methods: Patients undergoing tracheostomy from 2001-2012 were identified from the Medical Information Mart for Intensive Care-III database. Early tracheostomy (ET) was defined as less than the 25^th percentile of time from ICU admission to tracheostomy (TTT). Statistical analysis for tracheostomy timing on ICU length of stay (LOS) and mortality were conducted. Results: A total of 1,566 patients were included. Patients with ET had shorter ICU LOS (27.32 vs. 12.55 days, p<0.001) and lower mortality (12.9% vs. 9.0%, p=0.039). Multivariate logistic regression analysis found an association between increasing TTT and mortality (OR: 1.029, 95% CI 1.007-1.051, p=0.009). Conclusions: Our analysis revealed that patients with ET were more likely to have shorter ICU LOS and lower mortality. Our data suggests that ET should be given strong consideration in appropriately selected patients.