Mortality and patient disposition after ICU tracheostomy for secretion management vs. prolonged ventilation: a retrospective cohort study
Abstract Background There is little research on long-term, patient-centered outcomes in critically ill patients undergoing tracheostomy for secretion management or prolonged ventilation. The goal of this study was to determine and compare hospital and long-term mortality, and incidence of new instit...
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2025-02-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-025-02912-7 |
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| author | Dominique Dundaru-Bandi Linda M. Zhu Milana Schipper Paul J. Warshawsky Blair C. Schwartz |
| author_facet | Dominique Dundaru-Bandi Linda M. Zhu Milana Schipper Paul J. Warshawsky Blair C. Schwartz |
| author_sort | Dominique Dundaru-Bandi |
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| description | Abstract Background There is little research on long-term, patient-centered outcomes in critically ill patients undergoing tracheostomy for secretion management or prolonged ventilation. The goal of this study was to determine and compare hospital and long-term mortality, and incidence of new institutionalization amongst patients who underwent an ICU tracheostomy for these two aforementioned indications. Methods This was a single center historic cohort study of all ICU patients who received a tracheostomy for secretion management or prolonged ventilation from 2011 to 2022. We compared hospital and long-term mortality and incidence of new institutionalization between these two groups. Results A cohort of 247 patients (133 secretion management, 114 prolonged ventilation) was established. Overall hospital mortality was 86/247 (35%), mortality at 1 year was 106/207 (51%), and at 3 years was 117/167 (70%), with no significant difference between the two indications. Patients with prolonged ventilation indication had a significantly higher ICU mortality [34/114 (30%) vs. 13/133 (10%), P < 0.001]. Amongst hospital survivors, 49/137 (36%) were unable to return home, with significantly more patients tracheostomized for secretion management requiring new institutionalization [37/78 (47%) vs. 12/59 (20%), P = 0.002]. Conclusions Tracheostomy indication may be an important determinant of short- and long-term patient-centered outcomes. Patients receiving a tracheostomy for secretion management were twice as likely to be discharged to a new institution compared to prolonged ventilation patients. Patient-centered outcomes should be included in future studies and if confirmed, these outcomes should be incorporated into discussions about tracheostomy decision making. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | BMC Anesthesiology |
| spelling | doaj-art-f56171bff0854ba9b4d6c9a97e31475d2025-02-09T12:51:58ZengBMCBMC Anesthesiology1471-22532025-02-012511910.1186/s12871-025-02912-7Mortality and patient disposition after ICU tracheostomy for secretion management vs. prolonged ventilation: a retrospective cohort studyDominique Dundaru-Bandi0Linda M. Zhu1Milana Schipper2Paul J. Warshawsky3Blair C. Schwartz4Faculty of Medicine, McGill UniversityHôpital Sacre-Coeur, University of MontrealSpeech Language Pathology, Jewish General HospitalDepartment of Critical Care Medicine, McGill UniversityDepartment of Critical Care Medicine, McGill UniversityAbstract Background There is little research on long-term, patient-centered outcomes in critically ill patients undergoing tracheostomy for secretion management or prolonged ventilation. The goal of this study was to determine and compare hospital and long-term mortality, and incidence of new institutionalization amongst patients who underwent an ICU tracheostomy for these two aforementioned indications. Methods This was a single center historic cohort study of all ICU patients who received a tracheostomy for secretion management or prolonged ventilation from 2011 to 2022. We compared hospital and long-term mortality and incidence of new institutionalization between these two groups. Results A cohort of 247 patients (133 secretion management, 114 prolonged ventilation) was established. Overall hospital mortality was 86/247 (35%), mortality at 1 year was 106/207 (51%), and at 3 years was 117/167 (70%), with no significant difference between the two indications. Patients with prolonged ventilation indication had a significantly higher ICU mortality [34/114 (30%) vs. 13/133 (10%), P < 0.001]. Amongst hospital survivors, 49/137 (36%) were unable to return home, with significantly more patients tracheostomized for secretion management requiring new institutionalization [37/78 (47%) vs. 12/59 (20%), P = 0.002]. Conclusions Tracheostomy indication may be an important determinant of short- and long-term patient-centered outcomes. Patients receiving a tracheostomy for secretion management were twice as likely to be discharged to a new institution compared to prolonged ventilation patients. Patient-centered outcomes should be included in future studies and if confirmed, these outcomes should be incorporated into discussions about tracheostomy decision making.https://doi.org/10.1186/s12871-025-02912-7TracheostomySecretion managementProlonged ventilationIntensive care unitInstitutionalization |
| spellingShingle | Dominique Dundaru-Bandi Linda M. Zhu Milana Schipper Paul J. Warshawsky Blair C. Schwartz Mortality and patient disposition after ICU tracheostomy for secretion management vs. prolonged ventilation: a retrospective cohort study BMC Anesthesiology Tracheostomy Secretion management Prolonged ventilation Intensive care unit Institutionalization |
| title | Mortality and patient disposition after ICU tracheostomy for secretion management vs. prolonged ventilation: a retrospective cohort study |
| title_full | Mortality and patient disposition after ICU tracheostomy for secretion management vs. prolonged ventilation: a retrospective cohort study |
| title_fullStr | Mortality and patient disposition after ICU tracheostomy for secretion management vs. prolonged ventilation: a retrospective cohort study |
| title_full_unstemmed | Mortality and patient disposition after ICU tracheostomy for secretion management vs. prolonged ventilation: a retrospective cohort study |
| title_short | Mortality and patient disposition after ICU tracheostomy for secretion management vs. prolonged ventilation: a retrospective cohort study |
| title_sort | mortality and patient disposition after icu tracheostomy for secretion management vs prolonged ventilation a retrospective cohort study |
| topic | Tracheostomy Secretion management Prolonged ventilation Intensive care unit Institutionalization |
| url | https://doi.org/10.1186/s12871-025-02912-7 |
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