Tracheostomy After Cardiac Surgery: Timing of Tracheostomy as a Risk Factor for Mortality

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• 作者：Ronny Ben-Avi ; MD^* ; Alon Ben-Nun ; MD^* ; Shany Levin ; MA^&dagger ; ; David Simansky ; MD^* ; Nonna Zeitlin ; MD^* ; Leonid Sternik ; MD^&dagger ; ; Ehud Raanani ; MD^&dagger ; ; Alexander Kogan ; MD^&dagger ; ; ^{alexanderkogan140@hotmail.com" class="auth_mail} ; ^{Alexander.Kogan@sheba.health.gov.il" class="auth_mail}
• 关键词：tracheostomy ; intensive care unit ; prolonged ventilation ; mortality ; cardiac surgery
• 刊名：Journal of Cardiothoracic and Vascular Anesthesia
• 出版年：June 2014
• 年：2014
• 卷：28
• 期：3
• 页码：493-496
• 全文大小：158 K

文摘

The optimal timing for tracheostomy after cardiac surgery in patients undergoing prolonged ventilation is controversial. The aim of this study was to assess the effect of tracheostomy timing on short- and long-term mortality of these patients.

Design

Retrospective study of prospectively collected data.

Setting

Cardiac surgical intensive care unit (ICU) in a tertiary-care, university-affiliated hospital.

Participants

All patients undergoing tracheostomy after cardiac surgery between September 2004 and March 2013 were included.

Interventions

The authors compared the outcome in 2 groups of patients according to the timing of tracheostomy: Group I, early-intermediate tracheostomy (0-14 days) and Group II, late tracheostomy (≥15 days).

Measurements and Main Results

During the study period, 6,069 patients underwent cardiac surgery; among them, 199 patients (3.26%) received a tracheostomy. There were 90 patients in Group I and 109 patients in Group II. There was no significant difference in the severity of the patients’ illness between the groups. The mortality rate at 3 months, 6 months, 1 year, and 2 years was 37%, 48%, 56%, and 58% in Group I, respectively, and 58%, 70%, 74%, and 77% in Group II, respectively (p< 0.01).

Conclusions

Early-intermediate (0-14 days) tracheostomy after cardiac surgery in patients requiring prolonged mechanical ventilation was associated with reduced mortality compared with late tracheostomy (≥15 days).