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Looking Beyond Hospital Discharge: One-Year Mortality Following Tracheostomy Creation in Traumatically Injured Older
Heather R Kregel1, Jan-Michael Van Gent2, Fatimah Sunez2
1Division of Acute Care Surgery, Department of Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Surgical Trials and Evidence-based Practice (CSTEP), McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Translational Injury Research, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas.
Introduction:
We aimed to evaluate long-term outcomes following tracheostomy in older trauma patients and hypothesized that 1-year survival decreases with older age.
Methods:
This was a descriptive analysis of intensive care unit patients ≥65 y old who underwent tracheostomy from 2015 to 2020. The National Death Index was accessed to determine time from tracheostomy creation to death. Groups were categorized by age. The primary outcome was 1-year mortality. Survival by age strata was analyzed using the Kaplan-Meier method.
Results:
Of 205 eligible patients, 125 (61%) were 65-74, 68 (33%) were 75-84, and 12 (6%) were >85 y old. Median injury severity scores and Charlson Comorbidity Index were similar between groups. One-year mortality increased by decade of life and median survival decreased by decade.
Conclusions:
In this cohort, 58% died within 1 year of tracheostomy, and increasing age was associated with shorter survival. Clear goals and expectations are needed when advising patients and families regarding tracheostomy.
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