Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

<jats:title>Abstract</jats:title><jats:sec><jats:title>Purpose</jats:title><jats:p>COVIDTrach is a UK multi-centre prospective cohort study project evaluating the outcomes of tracheostomy in patients with COVID-19 receiving mechanical ventilation. It also examines the incidence of SARS-CoV-2 infection among healthcare workers involved in the procedure.</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>An invitation to participate was sent to all UK NHS departments involved in tracheostomy in COVID-19 patients. Data was entered prospectively and clinical outcomes updated via an online database (REDCap). Clinical variables were compared with outcomes using multivariable regression analysis, with logistic regression used to develop a prediction model for mortality. Participants recorded whether any operators tested positive for SARS-CoV-2 within two weeks of the procedure.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The cohort comprised 1605 tracheostomy cases from 126 UK hospitals. The median time from intubation to tracheostomy was 15 days (IQR 11, 21). 285 (18%) patients died following the procedure. 1229 (93%) of the survivors had been successfully weaned from mechanical ventilation at censoring and 1049 (81%) had been discharged from hospital. Age, inspired oxygen concentration, PEEP setting, pyrexia, number of days of ventilation before tracheostomy, C-reactive protein and the use of anticoagulation and inotropic support independently predicted mortality. Six reports were received of operators testing positive for SARS-CoV-2 within two weeks of the procedure.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Tracheostomy appears to be safe in mechanically ventilated patients with COVID-19 and to operators performing the procedure and we identified clinical indicators that are predictive of mortality.</jats:p></jats:sec><jats:sec><jats:title>Funding</jats:title><jats:p>The COVIDTrach project is supported by the Wellcome Trust UCL COVID-19 Rapid Response Award and the National Institute for Health Research.</jats:p></jats:sec><jats:sec><jats:title>Trial registration</jats:title><jats:p>The study is registered with <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://ClinicalTrials.Gov">ClinicalTrials.Gov</jats:ext-link> (<jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="clintrialgov" xlink:href="NCT04572438">NCT04572438</jats:ext-link>).</jats:p></jats:sec>

Original publication

DOI

10.1101/2020.10.20.20216085

Type

Journal article

Publisher

Cold Spring Harbor Laboratory

Publication Date

27/10/2020