Predictors of short-term mortality in patients undergoing percutaneous dilatational tracheostomy

被引:17
作者
Pandian, Vinciya [1 ]
Gilstrap, Daniel L. [1 ]
Mirski, Marek A. [1 ]
Haut, Elliott R. [1 ]
Haider, Adil H. [1 ]
Efron, David T. [1 ]
Bowman, Natalie M. [1 ]
Yarmus, Lonny B. [1 ]
Bhatti, Nasir I. [1 ]
Stevens, Kent A. [1 ]
Vaswani, Ravi [1 ]
Feller-Kopman, David [1 ]
机构
[1] Johns Hopkins Univ Hosp, Baltimore, MD 21205 USA
关键词
Tracheostomy; Mortality; Critically ill; Intensive care; PROLONGED MECHANICAL VENTILATION; QUALITY-OF-LIFE; OUTCOMES; LONG; SURVIVAL; INJURY; STROKE; STAY; ICU;
D O I
10.1016/j.jcrc.2011.10.003
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Purpose: The purpose of the study was to identify the predictors of short-term mortality in patients undergoing percutaneous dilatational tracheostomy (PDT). Materials and Methods: Retrospective analysis of data pertaining to adult patients who underwent PDT between July 2005 and June 2008 in an urban, academic, tertiary care medical center was done. Clinical and demographic data were analyzed for 483 patients undergoing PDT via multivariate logistic regression. Results: Mortality data were examined at in-hospital, 14, 30, and 180 days postprocedure. Overall mortality rates were 11% at 14 days, 19% at 30 days, and 40% at 180 days. In-hospital mortality was 30%. Conclusions: Patients undergoing PDT have significant short-term mortality with 11% dying within 14 days and an in-hospital mortality rate of 30%. We identified an index diagnosis of ventilator-associated pneumonia and trauma to be associated with a higher survival rate, whereas older age, oncological diagnosis, cardiogenic shock, and ventricular-assist devices were associated with higher mortality. There is significant heterogeneity in both underlying diagnosis and patient outcomes, and these factors should be considered when deciding to perform this procedure and discussed with patients/family members to provide a realistic expectation of potential prognosis. (C) 2012 Elsevier Inc. All rights reserved.
引用
收藏
页码:420.e9 / 420.e15
页数:7
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