Characteristics and factors associated with mortality in tracheostomized patients with COVID-19: a retrospective cohort study in a hospital in Tacna, Peru

• Published in: Revista peruana de medicina experimental y salud pública Vol. 40; no. 4; pp. 441 - 450
• Main Authors: Flores Palacios, Rodrigo Jesús, Hueda Zavaleta, Miguel, Gutiérrez Avila, Andrés Guillermo, Gómez de la Torre, Juan Carlos, Benites Zapata, Vicente Aleixandre
• Format: Journal Article
• Language: Spanish; English
• Published: Peru Instituto Nacional de Salud 18.12.2023
• Subjects: Adult; COVID-19; Diabetes Mellitus, Type 2; Female; Hospital Mortality; Hospitals; Humans; Intensive Care Units; Male; Original; Peru; Procalcitonin; Respiratory Distress Syndrome; Retrospective Studies; Peru
• ISSN: 1726-4642; 1726-4634; 1726-4642
• DOI: 10.17843/rpmesp.2023.404.12629

We aimed to describe the main demographic, clinical, laboratory and therapeutic characteristics and to identify whether they are associated with mortality in tracheostomized patients. Retrospective cohort study in adult patients diagnosed with COVID-19, admitted to ICU (Intensive Care Unit) and requiring tracheostomy. Demographic, clinical, laboratory and treatment data were obtained from the medical records of patients admitted to Hospital III Daniel Alcides Carrión in Tacna. The Cox proportional hazards model was used for survival analysis and hazard ratios (HR) with their 95% confidence intervals (95%CI) were calculated. We evaluated 73 patients, 72.6% were men, the most common comorbidities were obesity (68.5%), type 2 diabetes mellitus (35.6%), and arterial hypertension (34.2%). Thirty-seven percent of the participants died during their stay at the ICU. The median time from intubation to tracheostomy and the duration of tracheostomy was 17 (RIC: 15-21) and 21 (RIC: 3-39) days, respectively. Multivariate analysis showed that the factors associated with mortality were procalcitonin > 0.50 ng/dL at the time of tracheostomy (HRa: 2.40 95%CI: 1.03-5.59) and a PaO2/FiO2 ratio less than or equal to 150 mmHg (HRa: 4.44 95%CI: 1.56-12.60). The factors associated with mortality at the time of tracheostomy were procalcitonin > 0.50 ng/dL and a PaO2/FiO2 ratio less than or equal to 150 mmHg.