TY - JOUR
T1 - Mortality and long-term quality of life after percutaneous tracheotomy in Intensive Care Unit
T2 - A prospective observational study
AU - Vargas, Maria
AU - Sutherasan, Yuda
AU - Brunetti, Iole
AU - Micalizzi, Camilla
AU - Insorsi, Angelo
AU - Ball, Lorenzo
AU - Folentino, Marta
AU - Sileo, Rosanna
AU - Delucia, Arduino
AU - Cerana, Manuela
AU - Accattatis, Alessandro
AU - Delisi, Domenico
AU - Gratarola, Angelo
AU - Mora, Francesco
AU - Peretti, Giorgio
AU - Servillo, Giuseppe
AU - Pelosi, Paolo
PY - 2018/9/1
Y1 - 2018/9/1
N2 - 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: Atotal of 137 patients were included in the study. In the multivariate analysis, ICU mortality was independently associated with age (OR1.089; P=0.003) and SAPSII(OR1.047; P=0.003), and inversely with neurologic disease (OR0.162; 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). Asubgroup analysis showed better QoLat 3-months, 6-months and 1-year in respiratory compared to neurological tracheostomized patients (P=0.01). CONCLUSIONS: Patients baseline characteristics and indication for PDTprocedure are important determinants of in- ICU mortality and QoLin tracheostomized patients.
AB - 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: Atotal of 137 patients were included in the study. In the multivariate analysis, ICU mortality was independently associated with age (OR1.089; P=0.003) and SAPSII(OR1.047; P=0.003), and inversely with neurologic disease (OR0.162; 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). Asubgroup analysis showed better QoLat 3-months, 6-months and 1-year in respiratory compared to neurological tracheostomized patients (P=0.01). CONCLUSIONS: Patients baseline characteristics and indication for PDTprocedure are important determinants of in- ICU mortality and QoLin tracheostomized patients.
KW - Follow-up studies
KW - Intensive care units
KW - Mortality
KW - Quality of life
KW - Tracheotomy
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U2 - 10.23736/S0375-9393.18.12133-X
DO - 10.23736/S0375-9393.18.12133-X
M3 - Article
AN - SCOPUS:85046486957
VL - 84
SP - 1024
EP - 1031
JO - Minerva Anestesiologica
JF - Minerva Anestesiologica
SN - 0375-9393
IS - 9
ER -