To the Editor Dr Young and colleagues1 conducted a multicenter, prospective study on tracheostomy timing involving 72 critical care units in the United Kingdom over an 8-year period. The authors randomized patients into early vs late tracheostomy groups and found comparable mortality, critical care unit length of stay, and tracheostomy complications. Although we agree with the major conclusion that study clinicians could not reliably predict who would need a tracheostomy, we suggest caution regarding other conclusions and those of the accompanying Editorial2 based on study limitations and a narrow set of outcome measures.
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