Trends in tracheostomy placement after out-of-hospital cardiac arrest
Purpose: Out-of-hospital cardiac arrest (OHCA) is a major public health burden. The purpose of this study was to assess the incidence of tracheostomy placement after OHCA and to evaluate trends over time and cost. Methods: Using the National Inpatient Sample data 2016–2021, we examined a weighted sa...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-05-01
|
| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520425000931 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850267861245755392 |
|---|---|
| author | Francisco Gallegos-Koyner Nelson Barrera Ricardo M. Carvalhais David H. Chong Anica Law Ari Moskowitz |
| author_facet | Francisco Gallegos-Koyner Nelson Barrera Ricardo M. Carvalhais David H. Chong Anica Law Ari Moskowitz |
| author_sort | Francisco Gallegos-Koyner |
| collection | DOAJ |
| description | Purpose: Out-of-hospital cardiac arrest (OHCA) is a major public health burden. The purpose of this study was to assess the incidence of tracheostomy placement after OHCA and to evaluate trends over time and cost. Methods: Using the National Inpatient Sample data 2016–2021, we examined a weighted sample of adults admitted after OHCA who underwent mechanical ventilation within the first 24 h of arrival and had an admission longer than 24 h. The primary outcome of interest was incidence of tracheostomy placement after cardiac arrest. Secondary outcomes of interest included hospitalization costs, days to tracheostomy placement, length of stay and discharge disposition. Results: A total of 47,550 admissions fulfilled the inclusion criteria. Of those, 1,450 (3.0%) patients received a tracheostomy during their hospitalization. There was no change in the incidence of tracheostomy placement over the analyzed years. Median hospitalization costs for patients with OHCA who received a tracheostomy were $96,038 (IQR= $66,415−$148,633). Hospitalization costs steadily increased over the analyzed years, from $83,668 in 2016 to $109,032 in 2021. Median days to tracheostomy placement was 11 days (IQR = 8–15) and median length of stay of patients with OHCA and tracheostomy was 23 days (IQR = 16–36). There was no significant change over the years in days to tracheostomy placement or in length of stay to explain the increase in hospitalization costs. Among patients with tracheostomy, 76.2% were discharged to a Skilled Nursing Facility, 13.8% died, 4.8% were discharged to a short-term hospital, and 5.2% were discharged home. Conclusions: An estimated 3.0% of patients who are admitted to the hospital after OHCA and require mechanical ventilation will receive a tracheostomy. Between 2016–2021 the rates and timing of tracheostomy placement remained stable in patients admitted with OHCA. However, we observed a rise in hospitalization costs associated with patients admitted for OHCA. |
| format | Article |
| id | doaj-art-70afcf80f3314f5ba5e256bcae021ac1 |
| institution | OA Journals |
| issn | 2666-5204 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj-art-70afcf80f3314f5ba5e256bcae021ac12025-08-20T01:53:37ZengElsevierResuscitation Plus2666-52042025-05-012310095610.1016/j.resplu.2025.100956Trends in tracheostomy placement after out-of-hospital cardiac arrestFrancisco Gallegos-Koyner0Nelson Barrera1Ricardo M. Carvalhais2David H. Chong3Anica Law4Ari Moskowitz5Department of Internal Medicine, SBH Health System, City University of New York School of Medicine, Bronx, NY, USADepartment of Internal Medicine, SBH Health System, City University of New York School of Medicine, Bronx, NY, USADivision of Critical Care Medicine, Department of Medicine, Montefiore Medical Center, Bronx, NY, USADepartment of Internal Medicine, SBH Health System, City University of New York School of Medicine, Bronx, NY, USASection of Pulmonary, Allergy, Sleep & Critical Care Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USADivision of Critical Care Medicine, Department of Medicine, Montefiore Medical Center, Bronx, NY, USA; Corresponding author at: Division of Critical Care Medicine, Department of Medicine, Montefiore Medical Center, Bronx, New York, USA.Purpose: Out-of-hospital cardiac arrest (OHCA) is a major public health burden. The purpose of this study was to assess the incidence of tracheostomy placement after OHCA and to evaluate trends over time and cost. Methods: Using the National Inpatient Sample data 2016–2021, we examined a weighted sample of adults admitted after OHCA who underwent mechanical ventilation within the first 24 h of arrival and had an admission longer than 24 h. The primary outcome of interest was incidence of tracheostomy placement after cardiac arrest. Secondary outcomes of interest included hospitalization costs, days to tracheostomy placement, length of stay and discharge disposition. Results: A total of 47,550 admissions fulfilled the inclusion criteria. Of those, 1,450 (3.0%) patients received a tracheostomy during their hospitalization. There was no change in the incidence of tracheostomy placement over the analyzed years. Median hospitalization costs for patients with OHCA who received a tracheostomy were $96,038 (IQR= $66,415−$148,633). Hospitalization costs steadily increased over the analyzed years, from $83,668 in 2016 to $109,032 in 2021. Median days to tracheostomy placement was 11 days (IQR = 8–15) and median length of stay of patients with OHCA and tracheostomy was 23 days (IQR = 16–36). There was no significant change over the years in days to tracheostomy placement or in length of stay to explain the increase in hospitalization costs. Among patients with tracheostomy, 76.2% were discharged to a Skilled Nursing Facility, 13.8% died, 4.8% were discharged to a short-term hospital, and 5.2% were discharged home. Conclusions: An estimated 3.0% of patients who are admitted to the hospital after OHCA and require mechanical ventilation will receive a tracheostomy. Between 2016–2021 the rates and timing of tracheostomy placement remained stable in patients admitted with OHCA. However, we observed a rise in hospitalization costs associated with patients admitted for OHCA.http://www.sciencedirect.com/science/article/pii/S2666520425000931Critical IllnessHeart ArrestNational Inpatient SampleTracheotomyOHCA |
| spellingShingle | Francisco Gallegos-Koyner Nelson Barrera Ricardo M. Carvalhais David H. Chong Anica Law Ari Moskowitz Trends in tracheostomy placement after out-of-hospital cardiac arrest Resuscitation Plus Critical Illness Heart Arrest National Inpatient Sample Tracheotomy OHCA |
| title | Trends in tracheostomy placement after out-of-hospital cardiac arrest |
| title_full | Trends in tracheostomy placement after out-of-hospital cardiac arrest |
| title_fullStr | Trends in tracheostomy placement after out-of-hospital cardiac arrest |
| title_full_unstemmed | Trends in tracheostomy placement after out-of-hospital cardiac arrest |
| title_short | Trends in tracheostomy placement after out-of-hospital cardiac arrest |
| title_sort | trends in tracheostomy placement after out of hospital cardiac arrest |
| topic | Critical Illness Heart Arrest National Inpatient Sample Tracheotomy OHCA |
| url | http://www.sciencedirect.com/science/article/pii/S2666520425000931 |
| work_keys_str_mv | AT franciscogallegoskoyner trendsintracheostomyplacementafteroutofhospitalcardiacarrest AT nelsonbarrera trendsintracheostomyplacementafteroutofhospitalcardiacarrest AT ricardomcarvalhais trendsintracheostomyplacementafteroutofhospitalcardiacarrest AT davidhchong trendsintracheostomyplacementafteroutofhospitalcardiacarrest AT anicalaw trendsintracheostomyplacementafteroutofhospitalcardiacarrest AT arimoskowitz trendsintracheostomyplacementafteroutofhospitalcardiacarrest |