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Scientific Oral Presentations

Laryngology/Broncho-Esophagology

Session: Scientific Oral Presentation 3 - Laryngology/Broncho-Esophagology

Impact of Planned Tracheostomy Timing on Survival and Complications in Critically Ill Patients

Monday, October 13, 2025

10:24 AM - 10:30 AM EDT

Location: 138

Disclosure(s):

Andrew V. Meci, MPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Tracheostomy timing, particularly early versus late planned procedures, is a critical factor influencing outcomes in critically ill patients. Using a multi-system database, we evaluate and compare clinical outcomes, including mortality, complications, and healthcare utilization, between early and late planned tracheostomy cohorts over a 10-year period. We present the largest study to date examining this question.

Methods: This study utilized the TriNetX global health research network to compare outcomes for patients receiving early (within 7 days of intubation) versus late (8 days to 1-month post-intubation) planned tracheostomies. The analysis included 26,136 patients from 104 healthcare organizations, aiming to guide optimal timing for improved survival and reduced complications. Our cohorts were defined as follows: early tracheostomy (Cohort A, n=11,051) and late tracheostomy (Cohort B, n=15,087). Key outcomes included mortality, hospital discharge, and tracheostomy-related complications. Kaplan-Meier survival analysis and risk analysis were used to assess differences over a 1-year period post-index event.

Results: The early tracheostomy cohort had a higher 1-year survival probability (68.23%) than the late cohort (63.76%, p< 0.001). Overall complication risk was slightly higher in the early cohort (11.6% vs. 10.3%, p=0.001), while specific complications such as hemorrhage showed no significant difference (p=0.187). The early cohort had a lower mortality hazard ratio (HR 0.838, p=0.008).

Conclusions: Early planned tracheostomy improves survival despite a modest increase in complication risk. These findings highlight the benefits of earlier intervention in suitable candidates. Future research should address strategies to reduce complication rates while maximizing survival benefits.

Presenting Author(s)

Andrew V. Meci, MPH

Medical Student
Penn State College of Medicine
Hershey, Pennsylvania, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

QJ

Qingli Ji, BS

The Pennsylvania State University, United States

Disclosure information not submitted.
DG

David Goldenberg, MD FACS

Professor and Chair
Hershey Med Center & Penn State Univ
Hershey, Pennsylvania, United States

Disclosure information not submitted.
NG

Neerav Goyal, MD MPH FACS

Professor; Division Chief Head and Neck Surgery; Vice Chair Patient Safety and Quality
Penn State Milton S Hershey Medical Center
Hershey, Pennsylvania, United States

Disclosure information not submitted.

Senior Author(s)

Vinciya Pandian, PhD, MBA, MSN

Associate Dean of Graduate Education and Professor of Nursing and Otolaryngology Head and Neck Surgery
The Pennsylvania State University College of Nursing
Forest Hill, MD, United States

Disclosure information not submitted.