Retrospective Cohort Study
Copyright ©The Author(s) 2024.
World J Methodol. Jun 20, 2024; 14(2): 91868
Published online Jun 20, 2024. doi: 10.5662/wjm.v14.i2.91868
Table 1 Baseline characteristics and comparison between patients who were subjected to tracheostomy and those who were not subjected to tracheostomy, n (%)

Total patients
Patients with tracheostomy
Patients without tracheostomy
P value
GenderMale375/660 (56.8)72/115 (62.6)303/545 (55.6)0.17
Female285/660 (43.2)43/115 (37.4)242/545 (44.4)
Age (yr)60.2 ± 16.860.1 ± 15.260.2 ± 17.10.97
Cause of admissionCNS345/660 (52.3)65/115 (56.5)280/545 (51.4)0.32
CVS28/660 (4.2)3/115 (2.6)25/545 (4.6)0.45
RS56/660 (8.5)11/115 (9.6)45/545 (8.3)0.65
Sepsis4/660 (0.6)4/115 (3.5)0/545 (0.0)0.001
Malignancy20/660 (3.0)7/115 (6.1)13/545 (2.4)0.06
Trauma59/660 (8.9)20/115 (17.4)39/545 (7.2)< 0.001
Surgery127/660 (19.2)2/115 (1.7)125/545 (22.9)< 0.001
Metabolic cause21/660 (3.2)3/115 (2.6)18/545 (3.3)1.00
Cause of intubationNot intubated19/660 (2.9)0/115 (0.0)19/545 (3.5)0.06
CNS191/660 (28.9)54/115 (47.0)137/545 (25.1)< 0.001
CVS31/660 (4.7)8/115 (7.0)23/545 (4.2)0.21
RS42/660 (6.4)10/115 (8.7)32/545 (5.9)0.26
Trauma34/660 (5.2)16/115 (13.9)18/545 (3.3)< 0.001
Metabolic cause34/660 (5.2)7/115 (6.1)27/545 (5.0)0.62
Compromised airway27/660 (4.1)13/115 (11.3)14/545 (2.6)< 0.001
Sepsis36/660 (5.5)7/115 (6.1)29/545 (5.3)0.74
Surgery246/660 (37.3)0/115 (0.0)246/545 (45.1)< 0.001
GCS (N)11.8 ± 4.59.6 ± 4.412.2 ± 4.4< 0.001
APACHE II (N)19.2 ± 8.019.0 ± 6.719.3 ± 8.50.65
APDR (%)35.0 ± 24.533.2 ± 20.135.7 ± 26.10.29
Number of co-morbidities (N)1.8 ± 1.51.75 ± 1.401.75 ± 1.490.97
Co-morbidityCardiovascular329/660 (49.8)56/115 (48.7)273/545 (50.1)0.79
Metabolic273/660 (41.4)46/115 (40.0)227/545 (41.7)0.74
Respiratory74/660 (11.2)13/115 (11.3)61/545 (11.2)0.97
Autoimmune10/660 (1.5)3/115 (2.6)7/545 (1.3)0.39
Malignancy83/660 (12.6)10/115 (8.7)73/545 (13.4)0.17
Psychiatric46/660 (7.0)10/115 (8.7)36/545 (6.6)0.42
Renal41/660 (6.2)6/115 (5.2)35/545 (6.4)0.63
Neurological42/660 (6.4)9/115 (7.8)33/545 (6.1)0.48
Hematological19/660 (2.9)3/115 (2.6)16/545 (2.9)1.00
Urological26/660 (3.9)3/115 (2.6)23/545 (4.2)0.60
Infectious10/660 (1.5)4/115 (3.5)6/545 (1.1)0.08
Days in ICU (N)7.1 ± 9.921.8 ± 10.74.0 ± 6.3< 0.001
Transferred toWard494/660 (74.8)75/115 (65.2)419/545 (76.9)0.009
Another hospital20/660 (3.0)11/115 (9.6)9/545 (1.7)< 0.001
Rehabilitation center10/660 (1.5)7/115 (6.1)3/545 (0.6)< 0.001
CCU6/660 (0.9)3/115 (2.6)3/545 (0.6)0.07
ICCU12/660 (1.8)0/115 (0.0)12/545 (2.2)0.24
SurvivalYes542/660 (82.1)96/115 (83.5)446/545 (81.8)0.68
No118/660 (17.9)19/115 (16.5)99/545 (18.2)
Table 2 Baseline characteristics of the patients who were subjected to tracheostomy and comparison between those who were subjected to early tracheostomy and those who were subjected to late tracheostomy, n (%)

Whole of the
patients
Patients with early tracheostomy
Patients with late tracheostomy
P value
GenderMale72/115 (62.6)40/63 (63.5)32/52 (61.5)0.83
Female43/115 (37.4)23/63 (36.5)20/52 (38.5)
Age (yr)60.1 ± 15.260.1 ± 14.360.2 ± 16.40.95
Cause of admissionCNS65/115 (56.5)38/63 (60.3)27/52 (51.9)0.37
CVS3/115 (2.6)1/63 (1.6)2/52 (3.9)0.59
RS11/115 (9.6)8/63 (12.7)3/52 (5.8)0.34
Sepsis4/115 (3.5)1/63 (1.6)3/52 (5.8)0.33
Malignancy7/115 (6.1)2/63 (3.2)5/52 (9.6)0.24
Trauma20/115 (17.4)10/63 (15.9)10/52 (19.2)0.64
Surgery2/115 (1.7)2/63 (3.2)0/52 (0.0)0.50
Metabolic3/115 (2.6)1/63 (1.6)2/52 (3.9)0.59
Cause of intubationCNS54/115 (47.0)32/63 (50.8)22/52 (42.3)0.36
CVS8/115 (7.0)5/63 (7.9)3/52 (5.8)0.73
RS10/115 (8.7)7/63 (11.1)3/52 (5.8)0.51
Trauma16/115 (13.9)8/63 (12.7)8/52 (15.4)0.68
Metabolic7/115 (6.1)2/63 (3.2)5/52 (9.6)0.24
Compromised airway13/115 (11.3)7/63 (11.1)6/52 (11.5)0.94
Sepsis7/115 (6.1)2/63 (3.2)5/52 (9.6)0.24
Surgery0/115 (0.0)0/63 (0.0)0/52 (0.0)N/A
GCS (N)9.6 ± 4.49.3 ± 4.110.1 ± 4.60.33
APACHE II (N)19.0 ± 6.718.3 ± 6.419.8 ± 7.00.25
APDR (%)33.2 ± 20.131.7 ± 18.735.0 ± 21.70.38
Number of co-morbidities (N)1.75 ± 1.401.75 ± 1.331.75 ± 1.490.99
Co-morbidityCardiovascular56/115 (48.7)34/63 (54.0)22/52 (42.3)0.21
Metabolic46/115 (40.0)22/63 (34.9)24/52 (46.2)0.22
Respiratory13/115 (11.3)7/63 (11.1)6/52 (11.5)0.94
Autoimmune3/115 (2.6)2/63 (3.2)1/52 (1.9)1.00
Malignancy10/115 (8.7)6/63 (9.5)4/52 (7.7)1.00
Psychiatric10/115 (8.7)6/63 (9.5)4/52 (7.7)1.00
Renal6/115 (5.2)4/63 (6.4)2/52 (3.9)0.69
Neurological9/115 (7.8)7/63 (11.1)2/52 (3.9)0.18
Hematological3/115 (2.6)1/63 (1.6)2/52 (3.9)0.59
Urological3/115 (2.6)1/63 (1.6)2/52 (3.9)0.59
Infectious4/115 (3.5)3/63 (4.8)1/52 (1.9)0.63
Reason for tracheostomyProlonged mechanical ventilation25/115 (21.7)9/63 (14.3)16/52 (30.8)0.033
Compromised
Airway
16/115 (13.9)9/63 (14.3)7/52 (13.5)0.90
Low level of
consciousness
49/115 (42.6)30/63 (47.6)19/52 (36.5)0.23
Myopathy
25/115 (21.7)15/63 (23.8)10/52 (19.2)0.55
Method of tracheostomy PDT96/115 (83.5)53/63 (84.1)43/52 (82.7)0.84
ST19/115 (16.5)10/63 (15.9)9/52 (17.3)
Reason for STFacial trauma5/19 (26.3)5/10 (50.0)0/9 (0.0)0.033
Cervical burn1/19 (5.3)0/10 (0.0)1/9 (11.1)0.47
Difficult airway6/19 (31.6)3/10 (30.0)3/9 (33.3)1.00
Cervical edema1/19 (5.3)1/10 (10.0)0/9 (0.0)1.00
Goiter4/19 (21.1)0/10 (0.0)4/9 (44.4)0.033
Re-opening2/19 (10.5)1/10 (10.0)1/9 (11.1)1.00
Complications0/115 (0.0)0/63 (0.0)0/52 (0.0)n/a
VAP31/115 (27.0)17/63 (27.0)14/52 (26.9)0.99
Pathogen isolatedNone11/47 (23.4)7/24 (29.2)4/23 (17.4)0.34
Candida albicans1/47 (2.1)1/24 (4.2)0/23 (0.0)1.00
Klebsiella pneumoniae4/47 (8.5)2/24 (8.3)2/23 (8.7)1.00
Acinetobacter baumanii15/47 (31.9)7/24 (29.2)8/23 (34.8)0.68
Pseudomonas aeruginosa10/47 (21.3)4/24 (16.7)6/23 (26.1)0.49
Staphylococcus aureus1/47 (2.1)0/24 (0.0)1/23 (4.4)0.49
Proteus mirabilis2/47 (4.3)0/24 (0.0)2/23 (8.7)0.23
Escherichia coli1/47 (2.1)1/24 (4.2)0/23 (0.0)1.00
Enterococcus faecium1/47 (2.1)1/24 (4.2)0/23 (0.0)1.00
Hemophilus influenzae1/47 (2.1)1/24 (4.2)0/23 (0.0)1.00
Days in ICU (N)21.8 ± 10.718.8 ± 9.125.4 ± 11.50.001
Transferred toWard75/115 (65.2)39/63 (61.9)36/52 (69.2)0.41
Another hospital11/115 (9.6)8/63 (12.7)3/52 (5.8)0.34
Rehabilitation center7/115 (6.1)3/63 (4.8)4/52 (7.7)0.70
CCU3/115 (2.6)3/63 (4.8)0/52 (0.0)0.25
ICCU0/115 (0.0)0/63 (0.0)0/52 (0.0)N/A
Condition at dischargeT-piece82/115 (71.3)43/53 (81.1)39/43 (90.7)0.19
Speaking valve1/115 (0.9)1/53 (1.9)0/43 (0.0)0.45
Tracheostomy closure5/115 (4.3)4/53 (7.6)1/43 (2.3)0.38
CPAP2/115 (1.7)2/53 (3.8)0/43 (0.0)0.50
BiPAP1/115 (0.9)1/53 (1.9)0/43 (0.0)1.00
Pressure ventilator3/115 (2.6)2/53 (3.8)1/43 (2.3)1.00
Volume ventilator2/115 (1.7)1/53 (1.9)1/43 (2.3)1.00
Breathing at dischargeUnassisted88/115 (76.5)47/53 (88.7)41/43 (95.3)0.29
Assisted8/115 (7.0)6/53 (11.3)2/43 (4.7)
Weaning from mechanical ventilation87/115 (75.7)48/60 (80.0)39/50 (78.0)0.80
Days on mechanical ventilation (N)18.6 ± 9.715.3 ± 8.522.8 ± 9.6< 0.001
SurvivalYes96/115 (83.5)53/63 (84.1)43/52 (82.7)0.84
No19/115 (16.5)10/63 (15.9)9/52 (17.3)
Table 3 Comparison between the patients who were subjected to percutaneous tracheostomy and those who were subjected to surgical tracheostomy, n (%)

Patients with PDT
Patients with ST
P value
GenderMale59/96 (61.5)13/19 (68.4)0.57
Female37/96 (38.5)6/19 (31.6)
Age (years)62.6 ± 14.047.6 ± 15.0< 0.001
Cause of admissionCNS60/96 (62.5)5/19 (26.3)0.004
CVS3/96 (3.1)0/19 (0.0)1.00
RS9/96 (9.4)2/19 (10.5)1.00
Sepsis3/96 (3.1)1/19 (5.3)0.52
Malignancy6/96 (6.3)1/19 (5.3)1.00
Trauma13/96 (13.5)7/19 (36.8)0.022
Surgery0/96 (0.0)2/19 (10.5)0.026
Metabolic2/96 (2.1)1/19 (5.3)0.42
Cause of intubationCNS51/96 (53.1)3/19 (15.8)0.003
CVS7/96 (7.3)1/19 (5.3)1.00
RS8/96 (8.3)2/19 (10.5)0.67
Trauma12/96 (12.5)4/19 (21.1)0.30
Metabolic6/96 (6.3)1/19 (5.3)1.00
Compromised airway7/96 (7.3)6/19 (31.6)0.008
Sepsis5/96 (5.2)2/19 (10.5)0.33
Surgery0/96 (0.0)0/19 (0.0)N/A
GCS (N)9.2 ± 4.311.7 ± 4.20.025
APACHE II (N)19.6 ± 6.415.7 ± 7.00.020
APDR (%)35.1 ± 20.323.6 ± 16.00.022
Number of co-morbidities (N)1.9 ± 1.51.2 ± 1.00.044
Co-morbidityCardiovascular52/96 (54.2)4/19 (21.1)0.008
Metabolic37/96 (38.5)9/19 (47.4)0.47
Respiratory10/96 (10.4)3/19 (15.8)0.45
Autoimmune3/96 (3.1)0/19 (0.0)1.00
Malignancy10/96 (10.4)0/19 (0.0)0.21
Psychiatric9/96 (9.4)1/19 (5.3)1.00
Renal6/96 (6.3)0/19 (0.0)0.59
Neurological8/96 (8.3)1/19 (5.3)1.00
Hematological3/96 (3.1)0/19 (0.0)1.00
Urological3/96 (3.1)0/19 (0.0)1.00
Infectious4/96 (4.2)0/19 (0.0)1.00
Reason for tracheostomyProlonged mechanical ventilation22/96 (22.9)3/19 (15.8)0.76
Compromised airway9/96 (9.4)7/19 (36.8)0.005
Low level of
consciousness
45/96 (46.9)4/19 (21.1)0.044
Myopathy20/96 (20.8)5/19 (26.3)0.56
Timing of tracheostomyEarly53/96 (55.2)10/19 (52.6)
1.00
Late43/96 (44.8)9/19 (47.4)
Reason for early tracheostomyProlonged duration of stay36/53 (67.9)0/10 (0.0)< 0.001
Compromised airway3/53 (5.7)5/10 (50.0)0.002
Trauma10/53 (18.9)3/10 (30.0)0.42
Neuromuscular disease4/53 (7.6)2/10 (20.0)0.24
Complications0/96 (0.0)0/19 (0.0)N/A
VAP25/96 (26.0)6/19 (31.6)0.62
Pathogen isolatedNone9/39 (23.1)2/8 (25.0)1.00
Candida albicans1/39 (2.6)0/8 (0.0)1.00
Klebsiella pneumoniae3/39 (7.7)1/8 (12.5)0.54
Acinetobacter baumanii13/39 (33.3)2/8 (25.0)1.00
Pseudomonas aeruginosa8/39 (20.5)2/8 (25.0)1.00
Staphylococcus aureus1/39 (2.6)0/8 (0.0)1.00
Proteus mirabilis1/39 (2.6)1/8 (12.5)0.32
Escherichia coli1/39 (2.6)0/8 (0.0)1.00
Enterococcus faecium1/39 (2.6)0/8 (0.0)1.00
Hemophilus influenzae1/39 (2.6)0/8 (0.0)1.00
Days in ICU (N)22.0 ± 10.920.7 ± 9.80.64
Transferred toWard65/96 (67.7)10/19 (52.6)0.29
Another hospital8/96 (8.3)3/19 (15.8)0.39
Rehabilitation center5/96 (5.2)2/19 (10.5)0.33
CCU1/96 (1.0)2/19 (10.5)0.07
ICCU0/96 (0.0)0/19 (0.0)N/A
Condition at dischargeT-piece68/79 (86.1)14/17 (82.4)0.71
Speaking valve0/79 (0.0)1/17 (5.9)0.18
Tracheostomy closure5/79 (6.3)0/17 (0.0)0.58
CPAP0/79 (0.0)2/17 (11.8)0.030
BiPAP1/79 (1.3)0/17 (0.0)1.00
Pressure ventilator3/79 (3.8)0/17 (0.0)1.00
Volume ventilator2/79 (2.5)0/17 (0.0)1.00
Breathing at dischargeUnassisted73/79 (92.4)15/17 (88.2)0.63
Assisted6/79 (7.6)2/17 (11.8)
Weaning from mechanical ventilation70/91 (76.9)17/19 (89.5)0.35
Days on mechanical ventilation (N)18.9 ± 9.717.6 ± 10.00.60
SurvivalYes79/96 (82.3)17/19 (89.5)0.74
No17/96 (17.7)2/19 (10.5)
Table 4 Comparison between the patients who survived and those who did not survived, n (%)

Survived
Did not survived
P value
GenderMale302/542 (55.7)73/118 (61.9)0.22
Female240/542 (44.3)45/118 (38.1)
Age (yr)59.8 ± 16.762.2 ± 17.40.16
Cause of admissionCNS288/542 (53.1)57/118 (48.3)0.36
CVS13/542 (2.4)15/118 (12.7)< 0.001
RS45/542 (8.3)11/118 (9.3)0.72
Sepsis4/542 (0.7)0/118 (0.0)1.00
Malignancy10/542 (1.9)10/118 (8.5)0.001
Trauma56/542 (10.3)3/118 (2.5)0.007
Surgery115/542 (21.2)12/118 (10.2)0.006
Metabolic11/542 (2.0)10/118 (8.5)0.001
Cause of intubationNot intubated19/542 (3.5)0/118 (0.0)0.033
CNS144/542 (26.6)47/118 (39.8)0.004
CVS14/542 (2.6)17/118 (14.4)< 0.001
RS33/542 (6.1)9/118 (7.6)0.54
Trauma30/542 (5.5)4/118 (3.4)0.34
Metabolic23/542 (4.2)11/118 (9.3)0.036
Compromised airway23/542 (4.2)4/118 (3.4)0.80
Sepsis11/542 (2.0)25/118 (21.2)< 0.001
Surgery245/542 (45.2)1/118 (0.9)< 0.001
GCS (N)12.6 ± 4.07.9 ± 4.8< 0.001
APACHE II (N)16.9 ± 7.025.1 ± 7.3< 0.001
APDR (%)27.4 ± 20.654.4 ± 23.0< 0.001
Number of co-morbidities (N)1.7 ± 1.52.1 ± 1.50.005
Co-morbidityCardiovascular260/542 (48.0)69/118 (58.5)0.039
Metabolic217/542 (40.0)56/118 (47.5)0.14
Respiratory56/542 (10.3)18/118 (15.3)0.13
Autoimmune8/542 (1.5)2/118 (1.7)0.70
Malignancy68/542 (12.6)15/118 (12.7)0.96
Psychiatric36/542 (6.6)10/118 (8.5)0.48
Renal31/542 (5.7)10/118 (8.5)0.26
Neurological34/542 (6.3)8/118 (6.8)0.84
Hematological11/542 (2.0)8/118 (6.8)0.011
Urological23/542 (4.2)3/118 (2.5)0.60
Infectious9/542 (1.7)1/118 (0.9)1.00
TracheostomyNo446/542 (82.3)99/118 (83.9)0.79
Yes96/542 (17.7)19/118 (16.1)
Reason for tracheostomyProlonged mechanical ventilation22/96 (22.9)3/19 (15.8)0.76
Compromised airway
13/96 (13.5)3/19 (15.8)0.73
Low level of
consciousness
41/96 (42.7)8/19 (42.1)0.96
Myopathy
20/96 (20.8)5/19 (26.3)0.56
Timing of tracheostomyEarly53/96 (55.2)10/19 (52.6)
0.84
Late43/96 (44.8)9/19 (47.4)
Reason for early tracheostomyProlonged duration of stay31/53 (58.5)5/10 (50.0)0.73
Compromised airway7/53 (13.2)1/10 (10.0)0.78
Trauma10/53 (18.9)3/10 (30.0)0.42
Neuromuscular disease5/53 (9.4)1/10 (10.0)1.00
Method of tracheostomy PDT79/96 (82.3)17/19 (89.5)
0.74
ST17/96 (17.7)2/19 (10.5)
Reason for STFacial trauma4/17 (23.5)1/2 (50.0)0.47
Cervical burn0/17 (0.0)1/2 (50.0)0.11
Difficult airway6/17 (35.3)0/2 (0.0)1.00
Cervical edema1/17 (5.9)0/2 (0.0)1.00
Goiter4/17 (23.5)0/2 (0.0)1.00
Re-opening2/17 (11.8)0/2 (0.0)1.00
Complications [N/T, (%)]0/96 (0.0)0/19 (0.0)n/a
VAP25/96 (26.0)6/19 (31.6)0.62
Pathogen isolatedNone8/40 (20.0)3/7 (42.9)0.33
Candida albicans1/40 (2.5)0/7 (0.0)1.00
Klebsiella pneumoniae4/40 (10.0)0/7 (0.0)1.00
Acinetobacter baumanii12/40 (30.0)3/7 (42.9)0.66
Pseudomonas aeruginosa9/40 (22.5)1/7 (14.3)1.00
Staphylococcus aureus1/40 (2.5)0/7 (0.0)1.00
Proteus mirabilis2/40 (5.0)0/7 (0.0)1.00
Escherichia coli1/40 (2.5)0/7 (0.0)1.00
Enterococcus faecium1/40 (2.5)0/7 (0.0)1.00
Hemophilus influenzae1/40 (2.5)0/7 (0.0)1.00
Days in ICU (N)6.7 ± 9.98.9 ± 9.80.028