Mortality and long-term quality of life after percutaneous tracheotomy in Intensive Care Unit: a prospective observational study.
Minerva Anestesiol
; 84(9): 1024-1031, 2018 09.
Article
em En
| MEDLINE
| ID: mdl-29338144
ABSTRACT
BACKGROUND:
Quality of life and mortality after percutaneous dilatational tracheotomy (PDT) has been poorly investigated. The aims of this study were to evaluate the independent risk factors for Intensive Care Unit (ICU) mortality and investigate quality of life over the first year after PDT in critically ill patients.METHODS:
This was a prospective, single-center, cohort study performed in a tertiary care University Hospital, enrolling consecutive ICU patients requiring elective PDT, collecting data during the tracheotomy procedure and the ICU stay. Follow-up was performed at three, six and twelve months after PDT. The medical interview included the Euro Quality of Life questionnaire comprising five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression).RESULTS:
A total of 137 patients were included in the study. In the multivariate analysis, ICU mortality was independently associated with age (OR 1.089; P=0.003) and SAPS II (OR 1.047; P=0.003), and inversely with neurologic disease (OR 0.162; P=0.004). Mortality increased over time (ICU mortality 26.7%; in-hospital mortality 43.1%; 3-months mortality 47.4%; 6-months mortality 61.3%; and 1-year mortality 70.8%; P=0.0001). Tracheostomized patients due to respiratory disease had a higher ICU mortality (50%) compared to those with neurological disease (13.6%). quality of life (QoL) of tracheostomized patients was severely compromised at 3-months (QoL 17, 15-19), 6-months (QoL 17; 16-19), while moderately compromised at 1-year (QoL 13; 9-16). A subgroup analysis showed better QoL at 3-months, 6-months and 1-year in respiratory compared to neurological tracheostomized patients (P=0.01).CONCLUSIONS:
Patients baseline characteristics and indication for PDT procedure are important determinants of in-ICU mortality and QoL in tracheostomized patients.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Qualidade de Vida
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Traqueotomia
Tipo de estudo:
Observational_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Minerva Anestesiol
Ano de publicação:
2018
Tipo de documento:
Article