Tracheostomy and long-term mortality in ICU patients undergoing prolonged mechanical ventilation


Autoři: Raphaël Cinotti aff001;  Sebastian Voicu aff002;  Samir Jaber aff003;  Benjamin Chousterman aff004;  Catherine Paugam-Burtz aff006;  Haikel Oueslati aff007;  Charles Damoisel aff005;  Anaïs Caillard aff004;  Antoine Roquilly aff001;  Fanny Feuillet aff009;  Alexandre Mebazaa aff004;  Etienne Gayat aff0040
Působiště autorů: Department of Anaesthesia and Critical Care, Hôpital Laennec, University Hospital of Nantes, Saint-Herblain, France aff001;  Department of Medical and Toxicological Intensive Care, Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris, Paris, France aff002;  Department of Anesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, University Hospital of Montpellier, France aff003;  INSERM UMR 942 “Biocanvass”, Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris, France aff004;  Department of Anaesthesia and Critical Care, Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris, Paris, France aff005;  Department of Anesthesia and Critical care department, Hôpital Beaujon, Assistance Publique des Hôpitaux de Paris, Clichy, France aff006;  Department of Anesthesia and Critical care department, Hôpital Saint-Louis, Assistance Publique des Hôpitaux de Paris, Paris, France aff007;  Laboratoire UPRES EA 3826 « Thérapeutiques cliniques et expérimentales des infections », University hospital of Nantes, Bio-Ouest, Institut de la Recherche, Nantes, France aff008;  INSERM UMR 1246 –SPHERE « Methods in Patient-Centered Outcomes and Health Research », Institut de la Recherche, Nantes, France aff009
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0220399

Souhrn

Introduction

In critically ill patients undergoing prolonged mechanical ventilation (MV), the difference in long-term outcomes between patients with or without tracheostomy remains unexplored.

Methods

Ancillary study of a prospective international multicentre observational cohort in 21 centres in France and Belgium, including 2087 patients, with a one-year follow-up after admission. We included patients with a MV duration ≥10 days, with or without tracheostomy. We explored the one-year mortality with a classical Cox regression model (adjustment on age, SAPS II, baseline diagnosis and withdrawal of life-sustaining therapies) and a Cox regression model using tracheostomy as a time-dependant variable.

Results

29.5% patients underwent prolonged MV, out of which 25.6% received tracheostomy and 74.4% did not. At one-year, 45.2% patients had died in the tracheostomy group and 51.5% patients had died in the group without tracheostomy (p = 0.001). In the Cox-adjusted regression model, tracheostomy was not associated with improved one-year outcome (HR CI95 0.7 [0.5–1.001], p = 0.051), as well as in the model using tracheostomy as a time-dependent variable (OR CI 95 1 [0.7–1.4], p = 0.9).

Conclusions

In our study, there was no statistically significant difference in the one-year mortality of patients undergoing prolonged MV when receiving tracheostomy or not.

Trial registration

NCT01367093

Klíčová slova:

Acute respiratory distress syndrome – Depression – Hospitals – Intensive care units – Observational studies – Quality of life – Respiratory failure – Tracheostomy


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Článek vyšel v časopise

PLOS One


2019 Číslo 10

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