{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T10:42:29Z","timestamp":1761648149482},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2014,5,7]],"date-time":"2014-05-07T00:00:00Z","timestamp":1399420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>The ideal timing of tracheostomy varies. This study sought to determine demographic, management, and outcome differences in patients undergoing early tracheostomy (ET) versus late tracheostomy (LT) (&lt;10 days vs. &gt;10 days postintubation, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective review of the 2008 to 2010 Nationwide Inpatient Sample for patients with extreme severity of illness who underwent tracheostomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients were subdivided based on the timing of tracheostomy placement (days 1\u20135, 6\u201310, 11\u201315, 16\u201320, 21\u201325). ET and LT were defined using a 10\u2010day cutoff. Descriptive statistics were obtained for hospital and patient demographics. Multivariate models analyzed the effect of tracheostomy timing on primary outcomes of in\u2010hospital morbidity\/mortality, length of stay (LOS), and charges.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 124,990 tracheostomy cases met inclusion criteria. Of the total cases, 53,749 underwent ET, and 71,244 underwent LT. Significant predictors (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.01) of ET included patient age &lt;65 years (odds ratio [OR]: 1.136), admission to a Midwest hospital (OR: 1.430), neurologic disorder (OR: 1.196), paralysis (OR: 1.264), and admission to a government, nonfederal hospital (OR: 1.434). Significant predictors of LT included admission to a small hospital (OR: 1.150), acute respiratory failure (OR: 1.601), and acute chronic respiratory failure (OR: 1.349). The economic outcomes of hospital costs and LOS increased linearly and significantly with time to tracheostomy, as did mortality (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). ET was associated with a significantly increased rate of discharge to home (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and decreased rate of sepsis (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and ventilator\u2010associated pneumonia (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Efficient and effective healthcare delivery is paramount in today's economic climate. Identification of patients likely to need prolonged ventilator support and ET may prove to be a cost\u2010 and morbidity\u2010saving measure and deserves further prospective examination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2c. <jats:italic>Laryngoscope<\/jats:italic>, 124:1801\u20131806, 2014<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.24702","type":"journal-article","created":{"date-parts":[[2014,4,5]],"date-time":"2014-04-05T08:31:13Z","timestamp":1396686673000},"page":"1801-1806","source":"Crossref","is-referenced-by-count":26,"title":["Outcomes of early versus late Tracheostomy: 2008\u20132010"],"prefix":"10.1002","volume":"124","author":[{"given":"Jennifer A.","family":"Villwock","sequence":"first","affiliation":[{"name":"Department of Otolaryngology SUNY\u2013Upstate Medical University Syracuse New York 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