Características y factores asociados a la mortalidad en pacientes con COVID-19 traqueostomizados: estudio de cohorte retrospectivo en un hospital de Tacna, Perú

Rodrigo Jesús Flores Palacios; Miguel Hueda Zavaleta; Andrés Guillermo Gutiérrez Avila; Juan Carlos Gómez de La Torre; Vicente Aleixandre Benites Zapata

doi:10.17843/rpmesp.2023.404.12629

Authors

Rodrigo Jesús Flores Palacios Hospital III Daniel Alcides Carrión, Tacna, Perú. Escuela de Posgrado, Universidad Privada de Tacna, Tacna, Perú. https://orcid.org/0000-0001-5374-7915
Miguel Hueda Zavaleta Hospital III Daniel Alcides Carrión, Tacna, Perú. Diagnóstico, tratamiento e investigación de enfermedades infecciosas y tropicales, Universidad Privada de Tacna, Tacna, Perú. https://orcid.org/0000-0002-8049-7787
Andrés Guillermo Gutiérrez Avila Hospital III Daniel Alcides Carrión, Tacna, Perú. https://orcid.org/0000-0002-4170-6603
Juan Carlos Gómez de La Torre Laboratorio Clínico Roe, Lima, Perú, https://orcid.org/0000-0003-4566-2027
Vicente Aleixandre Benites Zapata Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Perú. https://orcid.org/0000-0002-9158-1108

DOI:

https://doi.org/10.17843/rpmesp.2023.404.12629

Keywords:

Tracheostomy, Tracheotomy, Survival, SARS-CoV-2, COVID-19, Mortality, Peru, Risk Factors

Abstract

Objective. We aimed to describe the main demographic, clinical, laboratory and therapeutic characteristics and to identify whether they are associated with mortality in tracheostomized patients. Material and methods. 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. Results. 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). Conclusions. 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.

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