Early versus Late Tracheostomy in a Suburban Population: Clinical Profile, Complications, and Outcomes
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Abstract
Background: Tracheostomy is one of the most frequently performed procedures in intensive care units (ICUs). Despite its common use, the optimal timing, patient selection, and impact on outcomes remain debated. There is limited data on tracheostomy practices in suburban Indian populations.
Aim: To study the clinical profile, indications, complications, and outcomes of tracheostomised patients in a suburban population.
Materials and Methods: This observational study included 50 patients who underwent surgical tracheostomy between January 2023 and January 2026 at Rajalakshmi Medical College, Sriperumbudur, Tamil Nadu, India. Data were collected on demographic profile, primary diagnosis, indication for tracheostomy, type and timing of procedure, duration of mechanical ventilation, ICU and hospital stay, complications, and outcomes at discharge and three months. Statistical analysis was performed using chi-square test, Student’s t‑test, and ANOVA; p<0.05 was considered significant.
Results: The mean age was 44.22±19.83 years, with male predominance (76%). Head trauma was the most common indication (58%). Early tracheostomy (≤7 days) was performed in 74% of patients and was associated with significantly shorter duration of mechanical ventilation (3.35±2.08 vs. 14.61±7.03 days), ICU stay (7.2±5.3 vs. 24.3±4.2 days), and hospital stay (24.97±19.59 vs. 41±15.36 days) compared to late tracheostomy (>7 days). Complication rates were lower in the early group (8.10% vs. 46.15%). At three months, 64.86% of early tracheostomy patients improved, whereas 61.53% of late tracheostomy patients expired (p=0.0001).
Conclusion: Early tracheostomy (≤7 days) is associated with reduced mechanical ventilation duration, shorter ICU and hospital stays, fewer complications, and improved three-month survival compared to late tracheostomy. In patients with an established need for prolonged airway support, earlier intervention is more rewarding than delayed management.
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