SynthesisBritish journal of anaesthesia2022
Bayesian analysis of a systematic review of early versus late tracheostomy in ICU patients.
Synthesis in British journal of anaesthesia, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07769021 (Observational iNternational Study of TRACHeostomy Practice in Adult Intensive Care Units - ON TRACH), which is not on this map. Cited by 9 papers, 2 of them syntheses that pooled it.
What it found
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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.
Observational iNternational Study of TRACHeostomy Practice in Adult Intensive Care Units - ON TRACH
Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Early versus late tracheostomy in critically ill patients: an umbrella review of systematic reviews of randomised clinical trials with meta-analyses and trial sequential analysis.BMJ open respiratory research · 2025Pooled it
- Early tracheostomy in severe traumatic brain injury: an umbrella systematic review.Brazilian journal of anesthesiology (Elsevier)Pooled it
- Early Versus Late Tracheostomy: An Umbrella Review and Meta-Analysis.Journal of clinical medicine · 2026Review
- Bayesian Thinking in the Intensive Care Unit: From Statistical Theory to Clinical Practice.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Article
- Impact of tracheostomy on clinical outcomes in ventilated patients with severe pneumonia: a propensity-matched cohort study.The Korean journal of internal medicine · 2025Observational
- Article
- Early tracheostomy in ventilated COVID-19 patients reduces incidence of ventilator-associated pneumonia.Scientific reports · 2024Article
- [Tracheotomy : Indication and implementation].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2024Review
- Timing of Tracheostomy in ICU Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Life (Basel, Switzerland) · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA recent systematic review and meta-analysis of RCTs of early vs late tracheostomy in mechanically ventilated patients suggest that early tracheostomy reduces the duration of ICU stay and mechanical ventilation, but does not reduce short-term mortality or ventilator-associated pneumonia (VAP). Meta-analysis of randomised trials is typically performed using a frequentist approach, and although reporting confidence intervals, interpretation is usually based on statistical significance. To provide a robust basis for clinical decision-making, we completed the search used from the previous review and analysed the data using Bayesian methods to estimate posterior probabilities of the effect of early tracheostomy on clinical outcomes.
methodsThe search was completed for RCTS comparing early vs late tracheostomy in the databases PubMed, EMBASE, and Cochrane library in June 2022. Effect estimates and 95% confidence intervals were calculated for the outcomes short-term mortality, VAP, duration of ICU stay, and mechanical ventilation. A Bayesian meta-analysis was performed with uninformative priors. Risk ratios (RRs) and standardised mean differences (SMDs) with 95% credible intervals were reported alongside posterior probabilities for any benefit (RR<1; SMD<0), a small benefit (number needed to treat, 200; SMD<-0.5), or modest benefit (number needed to treat, 100; SMD<-1).
resultsNineteen RCTs with 3508 patients were included. Comparing patients with early vs late tracheostomy, the posterior probabilities for any benefit, small benefit, and modest benefit, respectively, were: 99%, 99%, and 99% for short-term mortality; 94%, 78%, and 51% for VAP; 97%, 43%, and 1% for duration of mechanical ventilation; and 97%, 75%, and 27% and for length of ICU stay.
conclusionsBayesian meta-analysis suggests a high probability that early tracheostomy compared with delayed tracheostomy has at least some benefit across all clinical outcomes considered.
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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.