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 aff004;
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:
https://doi.org/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
Klíčová slova:
Acute respiratory distress syndrome – Depression – Hospitals – Intensive care units – Observational studies – Quality of life – Respiratory failure – Tracheostomy
Zdroje
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