Tracheostomy after cardiac operations: In-hospital and long-term survival

Andrea Ballotta, Hassan Kandil, Tommaso Generali, Lorenzo Menicanti, Gabriele Pelissero, Marco Ranucci

Research output: Contribution to journalArticle

Abstract

Background: Patients with ventilator dependency after cardiac operations may require a tracheostomy. This study determined the hospital and postdischarge outcome in a series of patients who underwent a tracheostomy due to ventilator dependency after cardiac operations. Methods: Medical records of cardiac surgical patients were retrospectively reviewed for preoperative, intraoperative, and postoperative variables, and also prospective follow-up for all-cause mortality. All adult patients treated with tracheostomy due to postoperative ventilator dependency between January 1, 2004, and December 31, 2009, were admitted to the study. Statistical methods included a multivariable logistic regression analysis for hospital mortality and a Kaplan-Meier analysis with multivariable Cox regression model for postdischarge mortality. Results: The study group included 131 patients. The hospital mortality rate was 49%. The only independent predictor for hospital mortality was the number of fresh frozen plasma units transfused during the hospital stay (6% mortality risk increase per each unit transfused). Survival rate for patients discharged from the hospital was 61% at 1 year, 49% at 2 years, 45% at 3 years, and 34% at 5 years. Factors affecting death after discharge were concomitant postoperative heart failure (hazard ratio, 2.6) and the length of ventilator dependency. Conclusions: Patients with a respiratory failure without associated heart failure or neurologic dysfunction have a significantly better long-term outcome. Caution should be applied in the use of fresh frozen plasma in patients with postoperative respiratory failure and ventilator dependency requiring a tracheostomy.

Original languageEnglish
Pages (from-to)528-534
Number of pages7
JournalAnnals of Thoracic Surgery
Volume92
Issue number2
DOIs
Publication statusPublished - Aug 2011

Fingerprint

Tracheostomy
Mechanical Ventilators
Survival
Hospital Mortality
Mortality
Respiratory Insufficiency
Heart Failure
Kaplan-Meier Estimate
Neurologic Manifestations
Proportional Hazards Models
Medical Records
Length of Stay
Survival Rate
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Tracheostomy after cardiac operations : In-hospital and long-term survival. / Ballotta, Andrea; Kandil, Hassan; Generali, Tommaso; Menicanti, Lorenzo; Pelissero, Gabriele; Ranucci, Marco.

In: Annals of Thoracic Surgery, Vol. 92, No. 2, 08.2011, p. 528-534.

Research output: Contribution to journalArticle

Ballotta, Andrea ; Kandil, Hassan ; Generali, Tommaso ; Menicanti, Lorenzo ; Pelissero, Gabriele ; Ranucci, Marco. / Tracheostomy after cardiac operations : In-hospital and long-term survival. In: Annals of Thoracic Surgery. 2011 ; Vol. 92, No. 2. pp. 528-534.
@article{620c3c04fbc847329b5f3d54985c4f3a,
title = "Tracheostomy after cardiac operations: In-hospital and long-term survival",
abstract = "Background: Patients with ventilator dependency after cardiac operations may require a tracheostomy. This study determined the hospital and postdischarge outcome in a series of patients who underwent a tracheostomy due to ventilator dependency after cardiac operations. Methods: Medical records of cardiac surgical patients were retrospectively reviewed for preoperative, intraoperative, and postoperative variables, and also prospective follow-up for all-cause mortality. All adult patients treated with tracheostomy due to postoperative ventilator dependency between January 1, 2004, and December 31, 2009, were admitted to the study. Statistical methods included a multivariable logistic regression analysis for hospital mortality and a Kaplan-Meier analysis with multivariable Cox regression model for postdischarge mortality. Results: The study group included 131 patients. The hospital mortality rate was 49{\%}. The only independent predictor for hospital mortality was the number of fresh frozen plasma units transfused during the hospital stay (6{\%} mortality risk increase per each unit transfused). Survival rate for patients discharged from the hospital was 61{\%} at 1 year, 49{\%} at 2 years, 45{\%} at 3 years, and 34{\%} at 5 years. Factors affecting death after discharge were concomitant postoperative heart failure (hazard ratio, 2.6) and the length of ventilator dependency. Conclusions: Patients with a respiratory failure without associated heart failure or neurologic dysfunction have a significantly better long-term outcome. Caution should be applied in the use of fresh frozen plasma in patients with postoperative respiratory failure and ventilator dependency requiring a tracheostomy.",
author = "Andrea Ballotta and Hassan Kandil and Tommaso Generali and Lorenzo Menicanti and Gabriele Pelissero and Marco Ranucci",
year = "2011",
month = "8",
doi = "10.1016/j.athoracsur.2011.02.002",
language = "English",
volume = "92",
pages = "528--534",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "The Society of Thoracic Surgeons. Published by Elsevier Inc",
number = "2",

}

TY - JOUR

T1 - Tracheostomy after cardiac operations

T2 - In-hospital and long-term survival

AU - Ballotta, Andrea

AU - Kandil, Hassan

AU - Generali, Tommaso

AU - Menicanti, Lorenzo

AU - Pelissero, Gabriele

AU - Ranucci, Marco

PY - 2011/8

Y1 - 2011/8

N2 - Background: Patients with ventilator dependency after cardiac operations may require a tracheostomy. This study determined the hospital and postdischarge outcome in a series of patients who underwent a tracheostomy due to ventilator dependency after cardiac operations. Methods: Medical records of cardiac surgical patients were retrospectively reviewed for preoperative, intraoperative, and postoperative variables, and also prospective follow-up for all-cause mortality. All adult patients treated with tracheostomy due to postoperative ventilator dependency between January 1, 2004, and December 31, 2009, were admitted to the study. Statistical methods included a multivariable logistic regression analysis for hospital mortality and a Kaplan-Meier analysis with multivariable Cox regression model for postdischarge mortality. Results: The study group included 131 patients. The hospital mortality rate was 49%. The only independent predictor for hospital mortality was the number of fresh frozen plasma units transfused during the hospital stay (6% mortality risk increase per each unit transfused). Survival rate for patients discharged from the hospital was 61% at 1 year, 49% at 2 years, 45% at 3 years, and 34% at 5 years. Factors affecting death after discharge were concomitant postoperative heart failure (hazard ratio, 2.6) and the length of ventilator dependency. Conclusions: Patients with a respiratory failure without associated heart failure or neurologic dysfunction have a significantly better long-term outcome. Caution should be applied in the use of fresh frozen plasma in patients with postoperative respiratory failure and ventilator dependency requiring a tracheostomy.

AB - Background: Patients with ventilator dependency after cardiac operations may require a tracheostomy. This study determined the hospital and postdischarge outcome in a series of patients who underwent a tracheostomy due to ventilator dependency after cardiac operations. Methods: Medical records of cardiac surgical patients were retrospectively reviewed for preoperative, intraoperative, and postoperative variables, and also prospective follow-up for all-cause mortality. All adult patients treated with tracheostomy due to postoperative ventilator dependency between January 1, 2004, and December 31, 2009, were admitted to the study. Statistical methods included a multivariable logistic regression analysis for hospital mortality and a Kaplan-Meier analysis with multivariable Cox regression model for postdischarge mortality. Results: The study group included 131 patients. The hospital mortality rate was 49%. The only independent predictor for hospital mortality was the number of fresh frozen plasma units transfused during the hospital stay (6% mortality risk increase per each unit transfused). Survival rate for patients discharged from the hospital was 61% at 1 year, 49% at 2 years, 45% at 3 years, and 34% at 5 years. Factors affecting death after discharge were concomitant postoperative heart failure (hazard ratio, 2.6) and the length of ventilator dependency. Conclusions: Patients with a respiratory failure without associated heart failure or neurologic dysfunction have a significantly better long-term outcome. Caution should be applied in the use of fresh frozen plasma in patients with postoperative respiratory failure and ventilator dependency requiring a tracheostomy.

UR - http://www.scopus.com/inward/record.url?scp=79960935390&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79960935390&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2011.02.002

DO - 10.1016/j.athoracsur.2011.02.002

M3 - Article

C2 - 21481841

AN - SCOPUS:79960935390

VL - 92

SP - 528

EP - 534

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 2

ER -