Clinical Correlates to One Year Mortality Following Tracheostomy of Adult Intensive Care Patients - Abstract
Background: Tracheostomy is a common surgical procedure performed in the adult intensive care unit (ICU) population etc. Our objective was to identify characteristics associated with one year mortality in adult ICU patients following tracheostomy placement.
Methods: A retrospective chart review was conducted on adult ICU patients admitted at Penn State Hershey Medical Center between January 2004 and December 2009 (n=193) who had a first time tracheostomy. Using univariate statistical analysis with logistic regression and Bonferonni correction, the significance of individual
characteristics to one year mortality following tracheostomy was determined. Statistical significance was considered p< 0.05; all p values reported are Bonferonni-corrected values.
Results: Mortality at one year following tracheostomy was 21.2% (41 of 193 patients). A total of nine variables were found to have a statistically significant correlation with patient mortality: one week increase in continuous intravenous sedation length following tracheostomy (p=0.00057), fourteen day increase in total mechanical ventilation length (p=0.00082), hyperglycemia (p=0.00130), continuous intravenous vasopressor medication infusions during tracheostomy (p=0.00222), acute renal failure (p=0.00471), increased age (p=0.00892), continuous intravenous vasopressor medication infusions during ICU stay (p=0.01711), hemodialysis (p=0.02813), and a 10,000 cell/?L increase in peak white blood cell count (p=0.03574).
Conclusions: Clinical factors associated with increased mortality of adult ICU patients one year following tracheostomy were identified. These factors may indicate greater severity of systemic dysfunction in an already critically ill population leading to increased mortality.