One Year Mortality Rates of Tracheostomy Cases: Life after the Knife

Background: Long-term mortality of critically ill patients who undergo tracheostomies is not well known. Objective: To determine what percentage of patients remains alive after receiving tracheostomy after respiratory failure. Methods: We performed a single center, retrospective analysis of patients undergoing tracheotomies from our 986 bed tertiary care, urban, teaching, university hospital. With strict adherence to HIPAA rules, one year death data was collected by cross matching social security numbers and the death master file of the National Technical Information Service updated to March 2013. Using this government sponsored website, patients who died in sites outside of our institution were identified. Results: A total of 430 patients were identified and tracked based on their social security number. Only 74% of patients survived to discharge. There were no deaths attributable to the procedure itself such as bleeding, loss of airway, or surgical site infection. Overall survival at one year was 53%. Outcomes were worse for the Medical Intensive Care Unit (MICU) subset of patients with only 46% of patients alive at one year. Neurologic Intensive Care Unit (NICU) patients did better at 59% survival. Surgical Intensive Care Unit (SICU) patients did best at 63% survival. Surprisingly, 7% of patients died within one week of tracheostomy. Conclusion: Patients who receive a tracheostomy due to their critical illness often have poor long term survival. This mortality was not procedurally related, but appears to be a marker of underlying illness. This data is important to share with patients and family members as the decision is made to get informed consent for tracheostomy. Ricardo Restrepo1, Daron Kahn1, Pankaj Patel2, Bharat Awsare1 and Michael Baram1* 1Department of Medicine, Division of Pulmonary and Critical Care, Jefferson University Hospital, Thomas Jefferson University, Philadelphia, USA 2Department of Surgery, Division of Trauma, Jefferson University Hospital, Thomas Jefferson University, Philadelphia, USA One Year Mortality Rates of Tracheostomy Cases: Life after the Knife

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