ArticleCritical care medicine2016
Hospital Variation in Early Tracheostomy in the United States: A Population-Based Study.
Article in Critical care medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 4 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Liberation from mechanical ventilation in critically ill patients: Korean Society of Critical Care Medicine Clinical Practice Guidelines.Acute and critical care · 2024Guideline
- The Royal College of surgeons multidisciplinary guidelines on elective tracheostomy insertion in COVID-19 ventilated patients.The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland · 2021Guideline
- Guideline
- Timing of tracheostomy in patients with prolonged endotracheal intubation: a systematic review.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2018Pooled it
- Implications of tracheostomy after acute type A aortic dissection repair: Longitudinal outcomes and factors associated with patients requiring it.JTCVS open · 2025Article
- Association of early versus late tracheostomy with prognosis in hypoxic-ischaemic encephalopathy patients: A propensity-matched cohort study.Nursing in critical care · 2025Observational
- Article
- Predicting Tracheostomy Need on Admission to the Intensive Care Unit-A Multicenter Machine Learning Analysis.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2024Article
- Liberation from Mechanical Ventilation in Critically Ill Patients: Korean Society of Critical Care Medicine Clinical Practice Guidelines.Tuberculosis and respiratory diseases · 2024Article
- The impact of delayed tracheostomy on critically ill patients receiving mechanical ventilation: a retrospective cohort study in a chinese tertiary hospital.BMC anesthesiology · 2024Article
- Tracheostomies for respiratory failure are associated with a high inpatient mortality: a potential trigger to reconsider goals of care.Trauma surgery & acute care open · 2024Article
- Healthcare Trajectories and Outcomes in the First Year After Tracheostomy Based on Patient Characteristics.Critical care medicine · 2023Article
- Trends for Percutaneous Tracheostomy in Italian Acute Care Setting over a 5-Year Period.Medicina (Kaunas, Lithuania) · 2023Article
- Temporal Trends and Variation in Bronchoscopy Use for Acute Respiratory Failure in the United States.Chest · 2023Observational
- Liberation From Mechanical Ventilation in the Cardiac Intensive Care Unit.JACC. Advances · 2023Review
- Tracheostomy decannulation rates in Japan: a retrospective cohort study using a claims database.Scientific reports · 2022Article
- Association Between Tracheostomy and Functional, Neuropsychological, and Healthcare Utilization Outcomes in the RECOVER Cohort.Critical care explorations · 2022Article
- A U-shaped association of tracheostomy timing with all-cause mortality in mechanically ventilated patients admitted to the intensive care unit: A retrospective cohort study.Frontiers in medicine · 2022Article
- Article
- State of the art: percutaneous tracheostomy in the intensive care unit.Journal of thoracic disease · 2021Review
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveControversy exists regarding perceived benefits of early tracheostomy to facilitate weaning among mechanically ventilated patients, potentially leading to significant practice-pattern variation with implications for outcomes and resource utilization. We sought to determine practice-pattern variation and outcomes associated with tracheostomy timing in the United States.
designIn a retrospective cohort study, we identified mechanically ventilated patients with the most common causes of respiratory failure leading to tracheostomy: pneumonia/sepsis and trauma. "Early tracheostomy" was performed within the first week of mechanical ventilation. We determined between-hospital variation in early tracheostomy utilization and the association of early tracheostomy with patient outcomes using hierarchical regression.
setting2012 National Inpatient Sample. PATIENTS: A total of 6,075 pneumonia/sepsis patients and 12,030 trauma patients with tracheostomy.
interventionsNone. MEASUREMENTS AND MAIN
resultsTrauma patients were twice as likely as pneumonia/sepsis patients to receive early tracheostomy (44.5% vs 21.7%; p < 0.001). Admission to hospitals with higher early tracheostomy-to-total-tracheostomy ratios was associated with increased risk for tracheostomy among mechanically ventilated trauma patients (adjusted odds ratio = 1.04; 95% CI, 1.01-1.07) but not pneumonia/sepsis (adjusted odds ratio =1.00; 95% CI, 0.98-1.02). We observed greater between-hospital variation in early tracheostomy rates among trauma patients (21.9-81.9%) compared with pneumonia/sepsis (14.9-38.3%; p < 0.0001). We found no evidence of improved hospital mortality. Pneumonia/sepsis patients with early tracheostomy had fewer feeding tube procedures and higher odds of discharge home.
conclusionEarly tracheostomy is potentially overused among mechanically ventilated trauma patients, with nearly half of tracheostomies performed within the first week of mechanical ventilation and large unexplained hospital variation, without clear benefits. Future studies are needed to characterize potentially differential benefits for early tracheostomy between disease subgroups and to investigate factors driving hospital variation in tracheostomy timing.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.