Abstract
PURPOSE: The first tracheostomy tube replacement is a critical procedure that can cause various complications, but there are few studies on the optimal timing of tracheostomy tube replacement in adult patients. This study aimed to evaluate the appropriate timing to replace the first tracheostomy tube to improve outcomes in adult patients. MATERIALS AND METHODS: This study was a retrospective cohort study that included 3957 patients aged ≥18 years who underwent the first tracheostomy tube change from January 2010 to February 2021. The primary outcome was all-cause mortality after the first tracheostomy tube change. RESULTS: The all-cause mortality was statistically significantly lower in group changing the first tracheostomy tube between 7 and 9 days than in other groups (42.1%, P = 0.001). After adjustments in the multivariable analyses, early first tracheostomy tube change within 6 days was independently associated with increased all-cause mortality. The hospital stay, ICU stay, and post-procedural pulmonary complications seemed to increase as the replacement time was delayed. CONCLUSIONS: The timing of the first tracheostomy tube change between 7 and 9 days after tracheostomy was associated with improved clinical outcomes, including all-cause mortality. Further prospective investigations are needed to determine whether the optimal timing of the first tracheostomy tube change can reduce mortality.