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- Title
Long-Term Survival in Patients With Tracheostomy and Prolonged Mechanical Ventilation in Olmsted County, Minnesota.
- Authors
Kojicic, Marija; Guangxi Li; Ahmed, Adil; Thakur, Lokendra; Trillo-Alvarez, Cesar; Cartin-Ceba, Rodrigo; Gay, Peter C.; Gajic, Ognjen
- Abstract
BACKGROUND: An increasing number of patients require prolonged mechanical ventilation (PMV), which is associated with high morbidity and poor long-term survival, but there are few data regarding the incidence and outcome of PMV patients from a community perspective. METHODS: We retrospectively reviewed the electronic medical records of adult Olmsted county, Minnesota, residents admitted to the intensive care units at the 2 Mayo Clinic Rochester hospitals from January 1, 2003, to December 31, 2007, who underwent tracheostomy for PMV. RESULTS: Sixty-five patients, median age 68 years (interquartile range [IQR] 49-80 y), 39 male, underwent tracheostomy for PMV, resulting in an age-adjusted incidence of 13 (95% CI 10-17) per 100,000 patient-years at risk. The median number of days on mechanical ventilation was 24 days (IQR 18- 37 d). Forty-six patients (71%) survived to hospital discharge, and 36 (55%) were alive at 1-year follow-up. After adjusting for age and baseline severity of illness, the presence of COPD was independently associated with 1-year mortality (hazard ratio 3.4, 95% CI 1.4-8.2%). CONCLUSIONS: There was a considerable incidence of tracheostomy for PMV. The presence of COPD was an independent predictor of 1-year mortality.
- Subjects
MINNESOTA; RESPIRATORY insufficiency treatment; ARTIFICIAL respiration; ANALYSIS of variance; APACHE (Disease classification system); CHI-squared test; CONFIDENCE intervals; FISHER exact test; INTENSIVE care units; OBSTRUCTIVE lung diseases; RESEARCH funding; RESPIRATORY insufficiency; STATISTICS; SURVIVAL analysis (Biometry); TRACHEOTOMY; DATA analysis; DISEASE incidence; PROPORTIONAL hazards models; RETROSPECTIVE studies; DATA analysis software
- Publication
Respiratory Care, 2011, Vol 56, Issue 11, p1765
- ISSN
0020-1324
- Publication type
Article
- DOI
10.4187/respcare.01096