Timing of tracheostomy
Our data demonstrated that patients that underwent early tracheostomy
had shorter subsequent lengths of hospital stay. There are a variety of
clinical factors including disease severity, medical therapy and
emerging evidence about viral load and infectivity, which will have
influenced decisions regarding timing of tracheostomy. The distinct
categorisation of patients into early and late tracheostomies, even when
outcomes are adjusted for patient factors, may be too simplistic.
However, our data suggests that there is no need to delay tracheostomy
insertion in the expectation that this will improve patient outcomes.
Indeed, there is evidence that delaying tracheostomy insertion may lead
to long-term complications such as tracheal
stenosis.17