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Hospital and Long-term Outcome After Tracheostomy for Respiratory Failure

Chest, 2004-01, Vol.125 (1), p.220-227 [Peer Reviewed Journal]

2004 The American College of Chest Physicians ;2004 INIST-CNRS ;Copyright American College of Chest Physicians Jan 2004 ;ISSN: 0012-3692 ;EISSN: 1931-3543 ;DOI: 10.1378/chest.125.1.220 ;PMID: 14718444 ;CODEN: CHETBF

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Title:
Hospital and Long-term Outcome After Tracheostomy for Respiratory Failure
Author: Engoren, Milo ; Arslanian-Engoren, Cynthia ; Fenn-Buderer, Nancy
Subjects: Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cardiology. Vascular system ; cost ; Female ; Health Care Costs ; Hospital Mortality ; Humans ; Length of Stay ; Male ; mechanical ventilation ; Medical sciences ; mortality ; Pneumology ; Proportional Hazards Models ; Respiration, Artificial ; respiratory failure ; Respiratory Insufficiency - economics ; Respiratory Insufficiency - mortality ; Respiratory Insufficiency - therapy ; Respiratory system : syndromes and miscellaneous diseases ; Retrospective Studies ; Risk Factors ; survival ; Survival Rate ; tracheostomy ; Tracheostomy - economics ; Treatment Outcome
Is Part Of: Chest, 2004-01, Vol.125 (1), p.220-227
Description: To determine the patient characteristics, hospital course, hospital cost, posthospital survival, and functional outcome in a group of patients with tracheostomy for respiratory failure. Retrospective chart review combined with prospective evaluation of functional status. An urban, tertiary-care medical center. Adult patients with tracheostomy for respiratory failure between January 1, 1998, and December 31, 2000. Retrospective chart review and prospective administration of the Short Form-36 (SF-36) for health status outcome. Four hundred twenty-nine patients were studied. Hospital mortality was 19%. Only 57% of survivors were liberated from mechanical ventilation. At 100 days, 6 months, 1 year, and 2 years after discharge, 24%, 30%, 36%, and 42% of hospital survivors had died, respectively. Patients liberated from mechanical ventilation and having their tracheostomy tubes decannulated had the lowest mortality (8% at 1 year); the mortality of ventilator-dependent patients was highest (57%). Sixty-six patients completed the SF-36 for functional status. While emotional health was generally good, physical function was quite limited. Median hospital direct variable cost was $29,340. Overall survival and functional status are poor in patients with tracheostomy for respiratory failure. Patients who are liberated from mechanical ventilation and have their tracheostomy tubes removed have the best survival; however, it comes at a higher hospital cost and longer length of stay.
Publisher: Northbrook, IL: Elsevier Inc
Language: English
Identifier: ISSN: 0012-3692
EISSN: 1931-3543
DOI: 10.1378/chest.125.1.220
PMID: 14718444
CODEN: CHETBF
Source: MEDLINE
ProQuest Central

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Hospital and Long-term Outcome After Tracheostomy for Respiratory Failure

2004 The American College of Chest Physicians ;2004 INIST-CNRS ;Copyright American College of Chest Physicians Jan 2004 ;ISSN: 0012-3692 ;EISSN: 1931-3543 ;DOI: 10.1378/chest.125.1.220 ;PMID: 14718444 ;CODEN: CHETBF

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