Evaluation of early and late percutaneous tracheostomy in geriatric patients in the intensive care unit Early and late percutaneous tracheostomy in geriatric patient

Aim: Percutaneous tracheostomy is a method frequently used in intensive care because of ease of implementation, can be open at the beside and has a low complication rate. Early tracheostomy was defined in 3-10 days of mechanical ventilation, late tracheostomy was defined at any time except the early period. Mortality risk rises with prolonged ventilation in the geriatric population. The first aim of this study is to search for the duration of hospital stay for the geriatric patients who underwent early and late percutaneous tracheostomy in the intensive care unit and its effect on 30-day mortality; and the second aim is to evaluate the complications of early and late tracheostomy. Material and Methods: Forty-six patients over 65 years of age who underwent percutaneous tracheostomy in the intensive care unit divided into two groups: within 3-10 days were grouped as ''early tracheostomy", and after 10 days as late tracheostomy". APACHE II scores, demographical data, indications, length of stay, discharge, 30-day mortality and complications during the procedure were recorded. Results: In late tracheostomies, the incidence of minor bleeding was less than in early tracheostomies, but the incidence of major complications such as subcutaneous emphysema, pneumothorax, and hypotension was higher. Hospital stay and intensive care durations were found to be shorter in patients who underwent early tracheostomy. Discussion: An early tracheostomy reduces the duration of hospital stay and has no effect on mortality and complications. Major complications after early tracheostomies were less common than in the late period. However, we think that this result should be investigated using randomized controlled studies with higher patient numbers.