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

Raphaël Cinotti, Sebastian Voicu, Samir Jaber, Benjamin Chousterman, Catherine Paugam-Burtz, Haikel Oueslati, Charles Damoisel, Anaïs Caillard, Antoine Roquilly, Fanny Feuillet, Alexandre Mebazaa, Etienne Gayat and On behalf of FROG-ICU Investigators

PLOS ONE, 2019, vol. 14, issue 10, 1-12

Abstract: 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

Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0220399

DOI: 10.1371/journal.pone.0220399

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