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Research ArticleOriginal Article
Open Access

Outcomes of tracheostomy in COVID-19 patients in National Guard Health Affairs, Riyadh, Saudi Arabia

Salwa ALHumaid, Mohammed A. Elkrim, Yazeed A. AlOqaili, Ghada A. AlSowailmi, Fahad A. AlObaid, Abdulaziz A. AlSalem, Mohammed A. AlQabasani, Yaseen M. Arabi and Hasan M. AlDorzi
Saudi Medical Journal November 2021, 42 (11) 1217-1222; DOI: https://doi.org/10.15537/smj.2021.42.11.20210505
Salwa ALHumaid
From the Division of Otolaryngology-Head and Neck Surgery (ALHumaid, Elkrim, AlOqaili, AlObaid, AlSalem, AlQabasani), Department of Surgery; from the Department of Intensive Care Unit (Arabi, AlDorzi), King Abdulaziz Medical City and King Abdullah Specialist Children’s Hospital National Guard Health Affairs, and from the College of Medicine (AlSowailmi), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
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Mohammed A. Elkrim
From the Division of Otolaryngology-Head and Neck Surgery (ALHumaid, Elkrim, AlOqaili, AlObaid, AlSalem, AlQabasani), Department of Surgery; from the Department of Intensive Care Unit (Arabi, AlDorzi), King Abdulaziz Medical City and King Abdullah Specialist Children’s Hospital National Guard Health Affairs, and from the College of Medicine (AlSowailmi), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
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Yazeed A. AlOqaili
From the Division of Otolaryngology-Head and Neck Surgery (ALHumaid, Elkrim, AlOqaili, AlObaid, AlSalem, AlQabasani), Department of Surgery; from the Department of Intensive Care Unit (Arabi, AlDorzi), King Abdulaziz Medical City and King Abdullah Specialist Children’s Hospital National Guard Health Affairs, and from the College of Medicine (AlSowailmi), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
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Ghada A. AlSowailmi
From the Division of Otolaryngology-Head and Neck Surgery (ALHumaid, Elkrim, AlOqaili, AlObaid, AlSalem, AlQabasani), Department of Surgery; from the Department of Intensive Care Unit (Arabi, AlDorzi), King Abdulaziz Medical City and King Abdullah Specialist Children’s Hospital National Guard Health Affairs, and from the College of Medicine (AlSowailmi), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
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  • For correspondence: [email protected]
Fahad A. AlObaid
From the Division of Otolaryngology-Head and Neck Surgery (ALHumaid, Elkrim, AlOqaili, AlObaid, AlSalem, AlQabasani), Department of Surgery; from the Department of Intensive Care Unit (Arabi, AlDorzi), King Abdulaziz Medical City and King Abdullah Specialist Children’s Hospital National Guard Health Affairs, and from the College of Medicine (AlSowailmi), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
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Abdulaziz A. AlSalem
From the Division of Otolaryngology-Head and Neck Surgery (ALHumaid, Elkrim, AlOqaili, AlObaid, AlSalem, AlQabasani), Department of Surgery; from the Department of Intensive Care Unit (Arabi, AlDorzi), King Abdulaziz Medical City and King Abdullah Specialist Children’s Hospital National Guard Health Affairs, and from the College of Medicine (AlSowailmi), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
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Mohammed A. AlQabasani
From the Division of Otolaryngology-Head and Neck Surgery (ALHumaid, Elkrim, AlOqaili, AlObaid, AlSalem, AlQabasani), Department of Surgery; from the Department of Intensive Care Unit (Arabi, AlDorzi), King Abdulaziz Medical City and King Abdullah Specialist Children’s Hospital National Guard Health Affairs, and from the College of Medicine (AlSowailmi), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
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Yaseen M. Arabi
From the Division of Otolaryngology-Head and Neck Surgery (ALHumaid, Elkrim, AlOqaili, AlObaid, AlSalem, AlQabasani), Department of Surgery; from the Department of Intensive Care Unit (Arabi, AlDorzi), King Abdulaziz Medical City and King Abdullah Specialist Children’s Hospital National Guard Health Affairs, and from the College of Medicine (AlSowailmi), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
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Hasan M. AlDorzi
From the Division of Otolaryngology-Head and Neck Surgery (ALHumaid, Elkrim, AlOqaili, AlObaid, AlSalem, AlQabasani), Department of Surgery; from the Department of Intensive Care Unit (Arabi, AlDorzi), King Abdulaziz Medical City and King Abdullah Specialist Children’s Hospital National Guard Health Affairs, and from the College of Medicine (AlSowailmi), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
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Tables

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    Table 1

    - The socio-demographic profiles of the participants (N=45).

    Demographical characteristicsn (%)
    Gender
    Male30 (66.7)
    Female15 (33.3)
    BMI
    Healthy2 (4.40)
    Overweight15 (33.30)
    Class 1 obesity17 (37.80)
    Class 2 obesity7 (15.60)
    Class 3 obesity4 (8.90)
    Age (mean±SD)66.67±12.74
    • BMI: body mass index, SD: standard deviation

    • View popup
    Table 2

    - The outcomes of the participants (N=45).

    Factorsn (%)
    Cause of death
    COVID-19 related death24 (53.3)
    Tracheostomy related death1 (2.2)
    No death20 (44.4)
    Weaning from ventilator
    Successfully weaned from mechanical ventilation11 (24.4)
    On ventilation at the time of data collection9 (20.0)
    Death25 (55.6)
    Duration from tracheostomy to death (in days), mean±SD (min - max)10.64±6.90 (2-25)
    Duration from tracheostomy to weaning (in days)* mean±SD (min - max)27.92±20.21 (2-82)
    • COVID-19: coronavirus disease -19, SD: standard deviation, *: survivors

    • View popup
    Table 3

    - The factors associated with patients’ mortalities.

    FactorsMortalitiesSurvivalsP-value*
    Mean±SD
    Duration from intubation to tracheostomy (in days)20.96±7.8620.20±6.490.730
    PEEP7.36±2.068.1±2.40.272
    FiO242.2±11.2842.75±10.060.865
    CRP before tracheostomy115.72±88.7490.15±106.030.383
    Use of inotropes, n (%)
    Yes16 (61.5)10 (38.5)0.345
    No9 (47.4)10 (52.6)
    CRP trend before tracheostomy, n (%)
    Uptrend12 (75)4 (25)0.039*
    Downtrend11 (42.3)15 (57.7)
    Method of tracheostomy, n (%)
    Open21 (61.8)13 (38.2)0.141
    Percutaneous4 (36.4)7 (63.6)
    • PEEP: positive end-expiratory pressure, FiO2: fraction of inspired oxygen CRP: C-reactive protein, SD: standard deviation, * significant at <0.05

    • View popup
    Table 4

    - The factors associated with duration from tracheostomy to weaning.

    FactorsTime from tracheostomy to weaningPearson correlationP-value
    Mean±SD
    Method of tracheostomy
    Open38.57±19.97 0.033*
    Percutaneous15.50±12.57  
    Correlation between duration from intubation to tracheostomy and duration from tracheostomy to weaning -0.630.84
    • SD: standard deviation, *: significant at <0.05

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Saudi Medical Journal: 42 (11)
Saudi Medical Journal
Vol. 42, Issue 11
1 Nov 2021
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Outcomes of tracheostomy in COVID-19 patients in National Guard Health Affairs, Riyadh, Saudi Arabia
Salwa ALHumaid, Mohammed A. Elkrim, Yazeed A. AlOqaili, Ghada A. AlSowailmi, Fahad A. AlObaid, Abdulaziz A. AlSalem, Mohammed A. AlQabasani, Yaseen M. Arabi, Hasan M. AlDorzi
Saudi Medical Journal Nov 2021, 42 (11) 1217-1222; DOI: 10.15537/smj.2021.42.11.20210505

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Outcomes of tracheostomy in COVID-19 patients in National Guard Health Affairs, Riyadh, Saudi Arabia
Salwa ALHumaid, Mohammed A. Elkrim, Yazeed A. AlOqaili, Ghada A. AlSowailmi, Fahad A. AlObaid, Abdulaziz A. AlSalem, Mohammed A. AlQabasani, Yaseen M. Arabi, Hasan M. AlDorzi
Saudi Medical Journal Nov 2021, 42 (11) 1217-1222; DOI: 10.15537/smj.2021.42.11.20210505
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Keywords

  • COVID-19
  • aerosol generating procedure
  • tracheostomy
  • prolonged intubation
  • personal protective equipment

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