A PROSPECTIVE STUDY ON OUTCOMES OF EARLY VERSUS LATE TRACHEOSTOMY IN ICU PATIENTS REQUIRING MECHANICAL VENTILATION

Background: Tracheostomy is frequently performed in critically ill patients requiring prolonged mechanical ventilation, butthe optimal timing of the procedure remains debated. Early tracheostomy may facilitate ventilator weaning and reduce hospitalresource utilization. The aim is to compare the clinical outcomes of early versus late tracheostomy in ICU patients requiringprolonged mechanical ventilation, with particular emphasis on mechanical ventilation duration, hospital stay, complications,spigotting, and decannulation. Materials and Methods: A prospective comparative study was conducted at Mahatma GandhiMedical College Hospital and Research Institute, Pondicherry, from February 2022 to January 2025. Forty patients aged >18years requiring prolonged mechanical ventilation and elective tracheostomy were included. Twenty patients underwent earlytracheostomy within 7 days of intubation and 20 underwent late tracheostomy after 7 days. Demographic characteristics,indications, complications, duration of ventilation and hospital stay, spigotting, decannulation, and final outcomes wereassessed. Results: Mean mechanical ventilation duration was significantly shorter with early tracheostomy (8.72 ± 2.9 vs. 17.8± 5.3 days; p<0.001). Hospital stay was also shorter (28.7 ± 11.1 vs. 38.1 ± 8.9 days; p<0.05). Spigotting and decannulationwere higher in the early group (100% vs. 70%; p<0.05). Complications and mortality did not differ significantly. Conclusion:Early tracheostomy was associated with improved clinical outcomes, particularly shorter ventilation and hospital stay, withoutincreased significant morbidity.