Tracheostomy is a beneficial procedure for COVID-19 patients
requiring ventilatory weaning.
In our study having a tracheostomy was associated with lower in-hospital
mortality after adjustment for covariates. Patients selected for
tracheostomy will have been expected to meet specific criteria in terms
of lower ventilatory requirements and potential for rehabilitation.
Therefore, this finding is caveated as patient selection will have
influenced it. Patients selected for tracheostomy insertion will be
expected to survive and consequently there will be an inherent bias in
comparing outcomes of patients with and without a tracheostomy. This is
demonstrated by reduced odds of COVID-19 patients with multiple
co-morbidities having a tracheostomy in our cohort (Table 2). However,
despite early scepticism for its role in critically ill COVID-19
patients, our study adds further evidence that tracheostomy is a
beneficial intervention for COVID-19 patients requiring ventilatory
weaning. 16