Tracheostomy Practices in Adult Intensive Care Units: A Multicenter Point-Prevalence Study in Izmir (IZ-TRACH) (IZ-TRACH)

Tracheostomy Practices in Adult Intensive Care Units in Izmir, Turkey: A Multicenter Point-Prevalence Study

The primary objective of this study was to determine the point-prevalence of tracheostomy in adult intensive care units (ICUs) in Izmir and to characterize the documented reasons for postponement of tracheostomy, with attention to family-related deferral. Secondary objectives included tracheostomy indications, techniques, complications, timing, the relationship between illness severity (APACHE II) and mortality, and short-term outcomes. This multicenter, descriptive point-prevalence study was conducted across eleven adult ICUs in six hospitals on September 8, 2025. Of 282 adult patients present on the index day, 46 had a tracheostomy and formed the analytic subgroup. The study aimed to provide observational data on how tracheostomy is managed in a real-world clinical setting, focusing on the decision-making process and clinical characteristics associated with patient mortality.

Study Overview

• Status: Completed
• Conditions: Tracheostomy
• Intervention / Treatment: Procedure: Tracheostomy

Detailed Description

This investigation was designed as a multicentre, descriptive point-prevalence study. On the specified prevalence day, all patients aged ≥18 present on the prevalence day were screened; those with an established tracheostomy formed the analytic subgroup.

The data collection process involved:

• Documentation of ICU structural characteristics across eleven adult ICUs in six hospitals, including bed capacity and annual tracheostomy volumes.
• Evaluation of the interval from endotracheal intubation to tracheostomy and identification of documented reasons for any delay.
• Assessment of the association between APACHE II score and 30-day in-hospital mortality.
• A 30-day follow-up to assess mortality outcomes and causes of death.

• Study Type: Observational
• Enrollment (Actual): 282

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Bayrakli
    • Izmir, Bayrakli, Turkey (Türkiye)
      • İzmir City Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Adult patients (aged ≥18 years) present in eleven participating adult intensive care units across six hospitals in Izmir, Turkey, on the point-prevalence day. Patients with a surgical or percutaneous tracheostomy formed the analytic subgroup.

Description

Inclusion Criteria:

• Aged 18 years and older
• Present in a participating adult ICU on the point-prevalence day

Exclusion Criteria:

• Patients younger than 18 years

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Tracheostomy Patients; Adult patients (aged ≥18 years) hospitalized in intensive care units who have undergone either surgical or percutaneous tracheostomy.	Procedure: Tracheostomy; The application of surgical or percutaneous dilatational tracheostomy (Griggs guidewire dilating forceps or Ciaglia single-dilator techniques) for indications such as prolonged mechanical ventilation

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
30-day in-hospital mortality from the index date	The proportion of patients who died within 30 days of the index (point-prevalence) date. Because tracheostomies were prevalent (established before the survey), this is a point-prevalence snapshot rather than a procedure-anchored rate.	Up to 30 days after the index day
Point-prevalence of tracheostomy and documented reasons for postponement	The proportion of adult ICU patients with a tracheostomy on the index day, and the distribution of documented reasons for postponement of tracheostomy (including family-related deferral).	Day 1

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Intubation-to-tracheostomy interval (days)	Median days from endotracheal intubation to tracheostomy	From endotracheal intubation to tracheostomy, assessed through Day 1
Distribution of tracheostomy technique (surgical vs percutaneous)	Proportion of surgical versus percutaneous tracheostomies.	Day 1
Early and late complication rates by technique	Proportion of patients with early and late complications, by technique.	From tracheostomy through Day 1
APACHE II score and its discrimination for 30-day mortality	Discrimination (area under the ROC curve) of the admission APACHE II score for 30-day mortality.	Up to 30 days after the index day
Causes of death among non-survivors	Distribution of causes of death among non-survivors.	Up to 30 days after the index day

Collaborators and Investigators

• Sponsor: Izmir City Hospital
• Investigators: Study Director: Murat KAYKAC, M.D., İzmir City Hospital

Study record dates

Study Major Dates

• Study Start (Actual): September 8, 2025
• Primary Completion (Actual): October 8, 2025
• Study Completion (Actual): October 8, 2025

Study Registration Dates

• First Submitted: February 5, 2026
• First Submitted That Met QC Criteria: February 5, 2026
• First Posted (Actual): February 11, 2026

Study Record Updates

• Last Update Posted (Actual): June 22, 2026
• Last Update Submitted That Met QC Criteria: June 16, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Intensive care unit; Tracheostomy; Mechanical ventilation; Multidisciplinary decision-making; Point-prevalence study
• Additional Relevant MeSH Terms: Therapeutics; Surgical Procedures, Operative; Airway Management; Thoracic Surgical Procedures; Otorhinolaryngologic Surgical Procedures; Ostomy; Tracheostomy
• Other Study ID Numbers: 2025/352

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No