Effect of Timing of Tracheotomy on Clinical Outcomes: an Update Meta-analysis Including 11 Trials
Chinese Medical Sciences JournalVol. 28, Issue 3, Pages: 159-166(2013)
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Effect of Timing of Tracheotomy on Clinical Outcomes: an Update Meta-analysis Including 11 Trials
Affiliations:
Neurological Intensive Care Unit, the Affiliated Hospital of Medical College, Qingdao University,Shandong,Qingdao,China,266003
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Published Online:30 September 2013,
Published:2013
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Liang Shan, Rui Zhang, Lian-di Li. Effect of Timing of Tracheotomy on Clinical Outcomes: an Update Meta-analysis Including 11 Trials[J]. Chinese medical sciences journal, 2013, 28(3): 159-166.
DOI:
Liang Shan, Rui Zhang, Lian-di Li. Effect of Timing of Tracheotomy on Clinical Outcomes: an Update Meta-analysis Including 11 Trials[J]. Chinese medical sciences journal, 2013, 28(3): 159-166.DOI:
Effect of Timing of Tracheotomy on Clinical Outcomes: an Update Meta-analysis Including 11 Trials
Methods We searched electronic databases (up to February 27
2013) for both randomized control trials and observational studies satisfying the predefined inclusion criteria.Results We retrieved 11 reports of studies including a total of 13 705 patients. Early tracheotomy was associated with significant reductions in mortality [33.3% vs. 36.3%; relative risk (RR); 0.92; 95% confidence interval (CI): 0.88
: 98%) and duration of mechanical ventilation (mean difference: -6.53 days; 95% CI: -11.43
-1.63; I
2
: 100%). However
as compared with late tracheotomy
early tracheotomy did not reduce the incidence of hospital pneumonia (21.9% vs. 21.0%
RR: 0.85; 95% CI: 0.68
1.06; I
2
: 67%).Conclusions Early tracheotomy can reduce length of ICU stay
duration of mechanical ventilation and mortality but has no influence on hospital pneumonia when compared with late tracheotomy. Once the decision has been made about tracheotomy
clinical physicians should not hesitate to perform the procedure.
Abstract
Methods We searched electronic databases (up to February 27
2013) for both randomized control trials and observational studies satisfying the predefined inclusion criteria.Results We retrieved 11 reports of studies including a total of 13 705 patients. Early tracheotomy was associated with significant reductions in mortality [33.3% vs. 36.3%; relative risk (RR); 0.92; 95% confidence interval (CI): 0.88
: 98%) and duration of mechanical ventilation (mean difference: -6.53 days; 95% CI: -11.43
-1.63; I
2
: 100%). However
as compared with late tracheotomy
early tracheotomy did not reduce the incidence of hospital pneumonia (21.9% vs. 21.0%
RR: 0.85; 95% CI: 0.68
1.06; I
2
: 67%).Conclusions Early tracheotomy can reduce length of ICU stay
duration of mechanical ventilation and mortality but has no influence on hospital pneumonia when compared with late tracheotomy. Once the decision has been made about tracheotomy
clinical physicians should not hesitate to perform the procedure.