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No Effect of Tracheostomy Timing on Mortality
Mortality similar for early or late tracheostomy in patients on mechanical ventilation

TUESDAY, May 21 (HealthDay News) -- Patients on mechanical ventilation have similar mortality and other outcomes regardless of whether they receive a tracheostomy early or later after being put on ventilation, according to a study published in the May 22 issue of the Journal of the American Medical Association.

Duncan Young, D.M., from the John Radcliffe Hospital in Oxford, U.K., and colleagues randomly assigned 909 adults breathing with the aid of mechanical ventilation for less than four days and deemed likely to require at least an additional week of ventilation to early tracheostomy (within four days) or late tracheostomy (after 10 days if still indicated).

The researchers found that 91.9 percent of the early group and 44.9 percent of the late group received a tracheostomy. Mortality from any cause 30 days after randomization was 30.8 percent for the early group and 31.5 percent for the late group. The early and late groups also had similar two-year mortality (51.0 and 53.7 percent, respectively) and similar median length of stay in the critical care unit for survivors (13.0 versus 13.1 days, respectively). Tracheostomy-related complications occurred in 5.5 percent of the early group and 7.8 percent of the late group.

"For patients breathing with the aid of mechanical ventilation treated in adult critical care units in the United Kingdom, tracheostomy within four days of critical care admission was not associated with an improvement in 30-day mortality or other important secondary outcomes," Young and colleagues conclude.

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