Percutaneous and surgical tracheostomy in critically ill adult patients: a meta-analysis

Putensen, Christian; Theuerkauf, Nils; Guenther, Ulf; Vargas, Maria; Pelosi, Paolo

doi:10.1186/s13054-014-0544-7

Critical Care

Table 2 Quality of included studies

From: Percutaneous and surgical tracheostomy in critically ill adult patients: a meta-analysis

Study	Random assignment	Allocation concealment	Blinding	Adequate selection and description of study population	Comparability of groups	Pre-defined treatment protocol	Absence of confounders	Absence of cointerventions	*A priori* definition of outcome	ITT	Power analysis	Follow-up duration	Patients screened/included in trial	Reports on patients lost to follow-up	Planned or premature termination of study
Studies comparing PT vs. ST (pooled PT vs. ST, including MDT vs. ST)
Hazard and colleagues [36]	Yes	Unclear	No	Yes	Yes, no statistical differences in age, gender, duration of intubation, underlying diagnosis, APACHE II score and coagulation parameters	Yes	Yes	Yes	Yes	Yes	No	12 weeks after decannulation	NR/ 46	No	As planned
Crofts and colleagues [31]	Yes	No, randomization by alternating weeks	No	Yes	Yes, no statistical differences in age, gender, duration of intubation and APACHE II score	Yes	Yes	Yes	Yes	Yes	No	3 months	NR/ 53	No	As planned
Friedman and colleagues [34]	Yes	Unclear, randomization by random number tables	No	Yes	Yes, no statistical differences in age, gender, duration of intubation, underlying diagnosis, APACHE II score and coagulation parameters	Yes	Yes	Yes	Yes	Yes	No	NR	NR/ 53	No	As planned
Holdgaard and colleagues [38]	Yes	Unclear	No	Yes	Yes, no statistical differences in age, gender and duration of intubation	Yes	Yes	Yes	Yes	Yes	No	NR	NR/ 60	No	As planned
Gysin and colleagues [35]	Yes	Unclear, randomization by computer-generated random list	No	No	Yes, no statistical differences in age, gender and duration of intubation	Yes	Yes	Yes	Yes	Yes	No	3 months after decannulation	NR/ 70	Yes, 40 lost	As planned
Porter and Ivatury [42]	Yes	Unclear, randomization by sealed envelopes	No	No	Yes, no statistical differences in age, gender and duration of intubation	Yes	Yes	Yes	Yes	Yes	No	NR	NR/ 70	No	As planned
Heikkinen and colleagues [37]	Yes	No, randomization by the lot	No	No	Yes, no statistical differences in age, gender and duration of intubation	Yes	Yes	Yes	Yes	Yes	No	18 months	NR/ 57	Yes, 46 lost	As planned
Freeman and colleagues [33]	Yes	Unclear	No	Yes	Yes, no statistical differences in age, gender, duration of intubation, saps and coagulation parameters	Yes	Yes	Yes	Yes	Yes	No	Hospital discharge	NR/ 80	No	As planned (hospital discharge)
Melloni and colleagues [40]	Yes	Unclear	No	Yes	Yes, no statistical differences in age, gender, duration of intubation and SAPS II	Yes	Yes	Yes	Yes	Yes	No	6 months	NR/ 50	Yes, 32 lost	As planned (6 months)
Sustic and colleagues [44]	Yes	Unclear	No	Yes	Yes, no statistical differences in age and gender	Yes	Yes	Yes	Yes	Yes	No	ICU discharge	NR/ 16	No	As planned (ICU discharge)
Wu and colleagues [47]	Yes	Unclear, randomization by computer-generated random list	No	No	Yes, no statistical differences in age, gender, duration of intubation and underlying diagnosis	Yes	Yes	Yes	Yes	Yes	No	2 years	NR/ 83	Yes, 52 lost	As planned
Antonelli and colleagues [28]	Yes	Unclear, randomization by computer-generated random list	No	Yes	Yes, no statistical differences in age, gender, duration of intubation, underlying diagnosis and SAPS II	Yes	Yes	Yes	Yes	Yes	Yes	360d	825/ 139	Yes, 36 lost	As planned (12 months)
Tabaee and colleagues [45]	Yes	No, randomization by the last number of the medical record	No	No	Yes no statistical differences in age, gender and duration of intubation	Yes	Yes	Yes	Yes	Yes	No	1 week	45/43	No	As planned (1 week)
Silvester and colleagues [43]	Yes	Yes, by sealed envelopes	No	Yes	Yes, no statistical differences in age, gender, duration of intubation, underlying diagnosis, APACHE II score and coagulation parameters	Yes	Yes	Yes	Yes	Yes	Yes	15 to 40 months	298/ 200	Yes, 119 lost	Terminated early after 200 patients due to lack of power
Studies comparing different PT techniques (pooled MDT/SSDT vs. pooled GWDF/ RDT/BDT, including MDT/SSDT vs. GWDF alone)
Nates and colleagues [41]	Yes	Yes, randomization by sealed envelopes	No	Yes	Yes, no statistical differences in age, gender, duration of intubation, APACHE II score and coagulation parameters	Yes	Yes	Yes	Yes	Yes	No	Day 7	NR/ 100	Yes, 8 lost	As planned (day 7)
van Heurn and colleagues [46]	Yes	Unclear	No	No	Yes, no statistical differences in age, gender and duration of intubation	Yes	Yes	Yes	Yes	Yes	No	ICU discharge	NR/ 127	No	As planned (ICU discharge)
Ambesh and colleagues [26]	Yes	Unclear	No	Yes	Yes, no statistical differences in age, gender, duration of intubation, APACHE II score and BMI	Yes	Yes	Yes	Yes	Yes	No	8 weeks after decannulation	NR/ 60	Yes, 27 lost	As planned
Byhahn and colleagues [29]	Yes	Unclear, randomization by computer-generated random list	No	No	Yes, no statistical differences in age, gender, duration of intubation and BMI	Yes	Yes	Yes	Yes	Yes	No	NR	NR/ 70	No	As planned
Anon and colleagues [27]	Yes	Unclear, randomization by number block procedure	No	Yes	Yes, no statistical differences in age, gender, duration of intubation and APACHE II score	Yes	Yes	Yes	Yes	Yes	No	Day 282 ± 198	NR/ 53	Yes, 36 lost	As planned
Kaiser and colleagues [39]	Yes	Yes, randomization by sealed envelopes	No	Yes	Yes, statistically proven for age, gender, duration of intubation and SAPS II	Yes	Yes	Yes	Yes	Yes	No	NR	NR/ 100	No	As planned
Cianchi and colleagues [30]	Yes	Unclear, randomization by computer-generated random list	No	Yes	Yes, no statistical differences in age, gender, duration of intubation BMI and coagulation parameters	Yes	Yes	Yes	Yes	Yes	No	Hospital discharge	78/ 70	Yes, 0 lost	As planned
Fikkers and colleagues [32]	Yes	Yes, randomization by sealed envelopes	No	Yes	Yes, no statistical differences in age, gender, duration of intubation, SOFA score and BMI	Yes	Yes	Yes	Yes	Yes	No	3 months after decannulation	145/ 120	Yes, 73 lost	As planned

When adequate selection and description of the study population was classified as ‘no’, enough information was provided to ensure the patients met the criteria for inclusion in the systematic review (that is, critically ill, in an ICU, and so forth). APACHE, Acute Physiology and Chronic Health Evaluation; BDT, balloon dilatation tracheotomy; BMI, body mass index; GWDF, guide wire dilatation forceps; MDT, multiple dilatation tracheotomy; NR, not reported; PT, percutaneous tracheotomy; RDT, rotational dilatation tracheotomy; SAPS, Simplified Acute Physiology Score; SOFA, Sequential Organ Failure Assessment; SSDT, single step dilatation tracheotomy; ST, surgical tracheotomy; ITT, intention to treat.

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ISSN: 1364-8535

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