Long-term survival in patients with tracheostomy and prolonged mechanical ventilation in olmsted county, Minnesota

Marija Kojicic, Guangxi Li, Adil Ahmed, Lokendra Thakur, Cesar Trillo-Alvarez, Rodrigo Cartin-Ceba, Peter C. Gay, Ognjen Gajic

Research output: Contribution to journalReview articlepeer-review

16 Scopus citations

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: Sixtyfive 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.

Original languageEnglish (US)
Pages (from-to)1765-1770
Number of pages6
JournalRespiratory care
Volume56
Issue number11
DOIs
StatePublished - Nov 2011

Keywords

  • COPD
  • Mechanical ventilation
  • Survival
  • Tracheostomy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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