Outcome and survival following tracheostomy in patients85 years old

PurposeTo evaluate percutaneous dilatational tracheostomy in patients85years old: its complication rate and possible risk factors. In addition, to assess prognostic factors for short, intermediate and long term survival following the procedure.MethodsA retrospective case-control study of 72 patients85years who received percutaneous dilatation tracheotomy (PTD), compared to a control group of younger patients (n=182). Demographics, clinical and laboratory data were collected. Survival and risk for complications were analyzed.ResultsThe study group's mean age was 894. Twelve patients had complications, three (4.2%) were major. No significant difference was found in overall complication rates between the groups. Cerebrovascular disease with neurologic deficits and pre-procedure albumin levels were significantly associated with complications. Survival rates did not differ in 1week and 1month following procedure between study and control group. There was a significant difference in the 1-year survival rates between the patients85years and the control groups (18.1% vs. 34.4%, p=0.01, respectively). Congestive heart failure, a frailty score>0.27 and failure to wean from a cannula were associated with reduced 1-year survival.ConclusionPTD is safe for patients85years. Complication risk factors and reduced survival should be discussed with patients and families before conducting tracheostomies.Level of evidence3b.