{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T17:15:50Z","timestamp":1783703750545,"version":"3.55.0"},"reference-count":24,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respiratory Care"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The impact of tracheostomy timing on mortality in mechanically ventilated patients is inconclusive, partly because identifying patients who require a tracheostomy is challenging. This study aimed to assess the association between tracheostomy timing and mortality using risk stratification based on the Sepsis Tracheostomy Early Prediction (STeP) score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective cohort study used data from a Japanese Intensive Care Patient Database. Subjects with sepsis who required mechanical ventilation and underwent tracheostomy were included and classified into low- (0\u20132), moderate- (3\u20136), and high-risk (\u22657) groups based on the STeP score. Early (\u22647 d) and late (&gt;7 d) tracheostomy were compared within each group using 1:1 propensity score matching (PSM). Sensitivity analyses were performed using a generalized linear mixed-effects model with hospitals as a random effect to account for between-hospital variability and the inverse probability of treatment weighting. The primary outcome was the in-hospital mortality rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>After 1:1 PSM matching, 52, 114, and 404 matched pairs were obtained in the low-, moderate-, and high-risk groups, respectively. In the high-risk group, early tracheostomy was associated with a significantly lower mortality rate than late tracheostomy (28.0% vs 36.1%; odds ratio, 0.67, 95% CI 0.49\u20130.92). No significant differences were observed between low- and moderate-risk groups. These findings were consistent across sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Early tracheostomy was associated with lower mortality in high-risk subjects\u00a0as identified by the STeP score, whereas no such association was observed in low- and moderate-risk patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19433654261454987","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T15:39:44Z","timestamp":1783438784000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Stratification Using the Tracheostomy Early Prediction Score and the Association Between Early Tracheostomy and Mortality in Sepsis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3159-0333","authenticated-orcid":false,"given":"Kazuya","family":"Kikutani","sequence":"first","affiliation":[{"name":"Drs. Kikutani, Nishikimi, Kyo, Yamaga, Shimatani, Ota, Ohshimo, and Prof. Shime are affiliated with Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuaki","family":"Nishikimi","sequence":"additional","affiliation":[{"name":"Drs. Kikutani, Nishikimi, Kyo, Yamaga, Shimatani, Ota, Ohshimo, and Prof. Shime are affiliated with Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan."},{"name":"Dr. Nishikimi is affiliated with Department of Emergency and Critical Care Medicine, Aichi Medical University, Nagakute, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michihito","family":"Kyo","sequence":"additional","affiliation":[{"name":"Drs. Kikutani, Nishikimi, Kyo, Yamaga, Shimatani, Ota, Ohshimo, and Prof. Shime are affiliated with Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan."},{"name":"Dr. Kyo is affiliated with Department of Radiation Disaster Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Yamaga","sequence":"additional","affiliation":[{"name":"Drs. Kikutani, Nishikimi, Kyo, Yamaga, Shimatani, Ota, Ohshimo, and Prof. Shime are affiliated with Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0148-2924","authenticated-orcid":false,"given":"Tatsutoshi","family":"Shimatani","sequence":"additional","affiliation":[{"name":"Drs. Kikutani, Nishikimi, Kyo, Yamaga, Shimatani, Ota, Ohshimo, and Prof. Shime are affiliated with Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Ota","sequence":"additional","affiliation":[{"name":"Drs. Kikutani, Nishikimi, Kyo, Yamaga, Shimatani, Ota, Ohshimo, and Prof. Shime are affiliated with Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichiro","family":"Ohshimo","sequence":"additional","affiliation":[{"name":"Drs. Kikutani, Nishikimi, Kyo, Yamaga, Shimatani, Ota, Ohshimo, and Prof. Shime are affiliated with Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuaki","family":"Shime","sequence":"additional","affiliation":[{"name":"Drs. Kikutani, Nishikimi, Kyo, Yamaga, Shimatani, Ota, Ohshimo, and Prof. Shime are affiliated with Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"e_1_3_5_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.4798"},{"key":"e_1_3_5_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-022-04005-0"},{"key":"e_1_3_5_4_1","first-page":"1925","article-title":"Early versus late percutaneous dilational tracheostomy in critically ill patients anticipated requiring prolonged mechanical ventilation","volume":"125","author":"Zheng Y","year":"2012","unstructured":"3.Zheng Y, , Sui F, , Chen XK, et al. Early versus late percutaneous dilational tracheostomy in critically ill patients anticipated requiring prolonged mechanical ventilation. 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