Format

Send to

Choose Destination
See comment in PubMed Commons below
Intensive Care Med. 2008 Oct;34(10):1878-82. doi: 10.1007/s00134-008-1169-6. Epub 2008 Jun 3.

Ward mortality in patients discharged from the ICU with tracheostomy may depend on patient's vulnerability.

Author information

1
Critical Care Center, Hospital de Sabadell, CIBERES, Parc TaulĂ­ s/n., 08208 Sabadell, Spain. rfernandez@tauli.cat

Abstract

OBJECTIVE:

To determine the effect of discharge from the ICU with a tracheostomy tube on ward mortality and its relation to patient vulnerability.

DESIGN AND SETTING:

Retrospective single-center cohort study.

METHODS:

Database (2003-2006) review of patients undergoing mechanical ventilation (MV) > 24 h and discharged from the ICU with or without tracheostomy tube in place and followed up to hospital discharge or death. We recorded clinical characteristics, complications, major ICU procedures, subjective prognosis at ICU discharge (Sabadell score), and hospital outcome. Factors associated with ward mortality were analyzed by multiple logistic regression.

RESULTS:

From 3,065 patients admitted to the ICU, 1,502 needed MV > 24 h. Only 936 patients (62%) survived the ICU and were transferred to the ward; of these, 130 (13.9%) had a tracheostomy tube in place. Ward mortality was higher in patients with a tracheostomy tube in place than in those without (26 vs. 7%, P < 0.001). Increased ward mortality among cannulated patients was seen only in those with intermediate Sabadell score (24 vs. 9% in score 1, P = 0.02, and 38 vs. 24% in score 2, P = 0.06), but not in the "good prognosis" (2 vs. 2%, score 0) and "expected to die in hospital" (80 vs. 75%, score 3) groups. Multivariate analysis found three factors associated with ward mortality: age, tracheostomy tube in place, and Sabadell score.

CONCLUSION:

Lack of tracheostomy decannulation in the ICU appears to be associated with ward mortality, but only in the group with a Sabadell score of 1.

PMID:
18521568
DOI:
10.1007/s00134-008-1169-6
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Springer
    Loading ...
    Support Center