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The primary objective of this study was to determine the point-prevalence of tracheostomy in adult intensive care units (ICUs) in Izmir and to characterize the documented reasons for postponement of tracheostomy, with attention to family-related deferral. Secondary objectives included tracheostomy indications, techniques, complications, timing, the relationship between illness severity (APACHE II) and mortality, and short-term outcomes. This multicenter, descriptive point-prevalence study was conducted across eleven adult ICUs in six hospitals on September 8, 2025. Of 282 adult patients present on the index day, 46 had a tracheostomy and formed the analytic subgroup. The study aimed to provide observational data on how tracheostomy is managed in a real-world clinical setting, focusing on the decision-making process and clinical characteristics associated with patient mortality.
This investigation was designed as a multicentre, descriptive point-prevalence study. On the specified prevalence day, all patients aged ≥18 present on the prevalence day were screened; those with an established tracheostomy formed the analytic subgroup.
The data collection process involved:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Tracheostomy Patients | Adult patients (aged ≥18 years) hospitalized in intensive care units who have undergone either surgical or percutaneous tracheostomy. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tracheostomy | Procedure | The application of surgical or percutaneous dilatational tracheostomy (Griggs guidewire dilating forceps or Ciaglia single-dilator techniques) for indications such as prolonged mechanical ventilation |
| Measure | Description | Time Frame |
|---|---|---|
| 30-day in-hospital mortality from the index date | The proportion of patients who died within 30 days of the index (point-prevalence) date. Because tracheostomies were prevalent (established before the survey), this is a point-prevalence snapshot rather than a procedure-anchored rate. | Up to 30 days after the index day |
| Point-prevalence of tracheostomy and documented reasons for postponement | The proportion of adult ICU patients with a tracheostomy on the index day, and the distribution of documented reasons for postponement of tracheostomy (including family-related deferral). | Day 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Intubation-to-tracheostomy interval (days) | Median days from endotracheal intubation to tracheostomy | From endotracheal intubation to tracheostomy, assessed through Day 1 |
| Distribution of tracheostomy technique (surgical vs percutaneous) |
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Inclusion Criteria:
Exclusion Criteria:
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Adult patients (aged ≥18 years) present in eleven participating adult intensive care units across six hospitals in Izmir, Turkey, on the point-prevalence day. Patients with a surgical or percutaneous tracheostomy formed the analytic subgroup.
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| Name | Affiliation | Role |
|---|---|---|
| Murat KAYKAC, M.D. | Izmir City Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Izmir City Hospital | Izmir | Bayrakli | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D014139 | Tracheostomy |
| ID | Term |
|---|---|
| D058109 | Airway Management |
| D013812 | Therapeutics |
| D010030 | Ostomy |
| D013514 | Surgical Procedures, Operative |
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Proportion of surgical versus percutaneous tracheostomies.
| Day 1 |
| Early and late complication rates by technique | Proportion of patients with early and late complications, by technique. | From tracheostomy through Day 1 |
| APACHE II score and its discrimination for 30-day mortality | Discrimination (area under the ROC curve) of the admission APACHE II score for 30-day mortality. | Up to 30 days after the index day |
| Causes of death among non-survivors | Distribution of causes of death among non-survivors. | Up to 30 days after the index day |
| D013517 |
| Otorhinolaryngologic Surgical Procedures |
| D019616 | Thoracic Surgical Procedures |