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Tracheostomy and Gastrostomy in Geriatric Trauma Associated With High Postdischarge Mortality
Sherry M Boone1, Bryan R Collier1,2, Emily R Faulks1,2
1Department of Surgery, Division of Trauma and Surgical Critical Care, Carilion Clinic, Roanoke, VA.
Objectives:
Identify 5-year mortality rates in trauma patients greater than 18 years old who undergo tracheostomy and/or gastrostomy tube placement.
Design:
Retrospective convenience sample with two cohorts.
Setting:
Academic level 1 trauma center.
Patients:
Hospitalized patients admitted to the trauma service from July 2008 to December 2012 who underwent tracheostomy and/or gastrostomy tube placement.
Interventions:
Patients were placed into two cohorts: adult 18-64 and geriatric greater than or equal to 65; mortality data were obtained from the National Death Index.
Measurements And Main Results:
The primary outcome was 5-year mortality of both cohorts as well as those admitted who did not receive tracheostomy or gastrostomy. Univariate analysis was performed using Fisher exact and Wilcoxon signed-rank tests. Kaplan-Meier curves were plotted to examine mortality up to 5 years after discharge.
Conclusions:
Five-year postdischarge mortality is significantly higher in geriatric patients undergoing tracheostomy and/or gastrostomy after traumatic injury. Fifty percent die within the first 28 weeks following discharge and 93% die within 2 years.
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