Hostname: page-component-6766d58669-wvcvf Total loading time: 0 Render date: 2026-05-23T14:14:37.538Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluating tracheostomy techniques in severe coronavirus disease 2019: open vs. percutaneous approaches

Published online by Cambridge University Press:  04 April 2025

Dean G. Kennedy Open the ORCID record for Dean G. Kennedy [Opens in a new window] ,
Nicholas Y. K. Chong Open the ORCID record for Nicholas Y. K. Chong [Opens in a new window] ,
Michelle T. Wiegn ,
Jonathan M. Carnino  and
Jessica R. Levi
Dean G. Kennedy*
Affiliation:
Boston University School of Medicine, Boston, MA, USA
Nicholas Y. K. Chong
Affiliation:
Boston University School of Medicine, Boston, MA, USA
Michelle T. Wiegn
Affiliation:
Boston University, Boston, MA, USA
Jonathan M. Carnino
Affiliation:
Boston University School of Medicine, Boston, MA, USA
Jessica R. Levi
Affiliation:
Department of Otolaryngology – Head and Neck Surgery and Pediatrics, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
*
Corresponding author: Dean Kennedy; Email: dgkenn@bu.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

This study compares outcomes of open versus percutaneous tracheostomies in coronavirus disease 2019 patients to guide clinical decision-making based on disease severity.

Methods

A retrospective cohort study using the 2020 National Readmissions Database identified 4810 coronavirus disease 2019 patients (International Statistical Classification of Diseases and Related Health Problems 10th Revision code U071) who underwent tracheostomy. Of these, 2061 had open and 2749 had percutaneous tracheostomies. Patient demographics, severity (All Patient Refined-Diagnosis Related Groups) and outcomes (mortality, readmission, complications) were analysed using chi-squared tests, both overall and by severity.

Results

Mortality was higher in the percutaneous group (29.25 per cent) compared to the open group (26.35 per cent) (p = 0.0265). For severe cases (All Patient Refined-Diagnosis Related Groups 3–4), open tracheostomies had significantly lower mortality, readmission and complication rates (p < 0.05).

Conclusion

Open tracheostomies are associated with better outcomes in severe coronavirus disease 2019 cases. Percutaneous tracheostomies are effective in mild cases, but patient selection and procedural planning should consider disease severity. Future research should validate these findings.

Keywords

Covid-19TracheostomyOutcome AssessmentOtorhinolaryngologyHospital MortalityPatient ReadmissionSeverity of Illness Index

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 139 , Issue 11 , November 2025 , pp. 1047 - 1049
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Zumla, A, Chan, JF, Azhar, EI, Hui, DS, Yuen, KY. Coronaviruses - drug discovery and therapeutic options. Nat Rev Drug Discov 2016;15:327–47CrossRefGoogle ScholarPubMed
Guo, YR, Cao, QD, Hong, ZS, Tan, YY, Chen, SD, Jin, HJ, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status Mil Med Res 2020;7:11Google ScholarPubMed
Wu, Z, McGoogan, JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020;323:1239–42CrossRefGoogle Scholar
Möhlenkamp, S, Thiele, H. Ventilation of COVID-19 patients in intensive care units. Herz 2020; 45:329–31CrossRefGoogle ScholarPubMed
Mishra, P, Jedge, P, Kaushik, M, Artham, P, Kumari, S. Our experience of tracheostomy in COVID-19 Patients. Indian J Otolaryngol Head Neck Surg 2022;74:1–4CrossRefGoogle ScholarPubMed
HCUP. Introduction to the HCUP Nationwide Readmission Database (NRD). In https://hcup-us.ahrq.gov/db/nation/nrd/Introduction_NRD_2020.jsp [2020]Google Scholar
Maheshwaran, S, Thomas, SV, Raman, GK, Pookamala, S. Safety of percutaneous vs open tracheostomy on intubated patients in ICU setting: which one is better? Indian J Otolaryngol Head Neck Surg 2022;74(suppl 3):4978–81CrossRefGoogle ScholarPubMed
Cheung, NH, Napolitano, LM. Tracheostomy: epidemiology, indications, timing, technique, and outcomes. Respir Care 2014;59:895–915; discussion 916–19CrossRefGoogle ScholarPubMed
Cipriano, A, Mao, ML, Hon, HH, Vazquez, D, Stawicki, SP, Sharpe, RP, et al. An overview of complications associated with open and percutaneous tracheostomy procedures. Int J Crit Illn Inj Sci 2015;5:179–88Google ScholarPubMed
González-Muñoz, A, Ramírez-Giraldo, C, Peña Suárez, JD, Lozano-Herrera, J, Vargas Mendoza, I, Rodríguez Lima, DR. Open versus percutaneous tracheostomy in patients with COVID-19: retrospective cohort analysis. BMC Pulm Med 2023;23:306CrossRefGoogle ScholarPubMed
Rovira, A, Tricklebank, S, Surda, P, Whebell, S, Zhang, J, Takhar, A, et al. Open versus percutaneous tracheostomy in COVID-19: a multicentre comparison and recommendation for future resource utilization. Eur Arch Otorhinolaryngol 2021;278:2107–14CrossRefGoogle Scholar
Long, SM, Chern, A, Feit, NZ, Chung, S, Ramaswamy, AT, Li, C, et al. Percutaneous and open tracheostomy in patients with COVID-19: comparison and outcomes of an institutional series in New York City. Ann Surg 2021;273:403–9Google ScholarPubMed
Staibano, P, Levin, M, McHugh, T, Gupta, M, Sommer, DD. Association of tracheostomy with outcomes in patients with COVID-19 and SARS-CoV-2 transmission among health care professionals: a systematic review and meta-analysis. JAMA Otolaryngol Head Neck Surg 2021;147:646–55CrossRefGoogle ScholarPubMed
Tzotzos, SJ, Fischer, B, Fischer, H, Zeitlinger, M. Incidence of ARDS and outcomes in hospitalized patients with COVID-19: a global literature survey. Crit Care 2020;24:516CrossRefGoogle ScholarPubMed