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MINERVA ANESTESIOLOGICA

Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Minerva Anestesiologica 2018 Jan 16

DOI: 10.23736/S0375-9393.18.12133-X

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Mortality and long-term quality of life after percutaneous tracheotomy in Intensive Care Unit: a prospective observational study

Maria VARGAS 1 2 , Yuda SUTHERASAN 3, Iole BRUNETTI 1, Camilla MICALIZZI 1, Angelo INSORSI 1, Lorenzo BALL 1, Marta FOLENTINO 1, Rosanna SILEO 1, Arduino DE LUCIA 1, Manuela CERANA 1, Alessandro ACCATTATIS 1, Domenico DE LISI 1, Angelo GRATAROLA 4, Francesco MORA 5, Giorgio PERETTI 5, Giuseppe SERVILLO 2, Paolo PELOSI 1

1 Department of Surgical Sciences and Integrated Diagnostics, San Martino Policlinico Hospital, IRCCS for Oncology, University of Genoa, Genoa, Italy; 2 Department of Neurosciences, Reproductive and Odonthostomatologic Sciences, University of Naples “Federico II”, Naples, Italy; 3 Division of Pulmonary and Critical Care Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 4 Division of Anesthesia and Intensive Care, Ospedale Policlinico San Martino IRCCS per l’Oncologia, Genoa, Italy; 5 Department of Otorhinolaryngology, Head and Neck Surgery, Ospedale Policlinico San Martino IRCCS per l’Oncologia, University of Genoa, Genoa, Italy


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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 3, 6 and 12 months after PDT. The medical interview included the Euro Quality of Life questionnaire comprising 5 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.


KEY WORDS: Tracheotomy - Mortality - Follow-up - Quality of life - Intensive care unit

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Publication History

Article first published online: January 16, 2018
Manuscript accepted: January 8, 2018
Manuscript revised: October 10, 2017
Manuscript received: April 11, 2017

Per citare questo articolo

Vargas M, Sutherasan Y, Brunetti I, Micalizzi C, Insorsi A, Ball L, et al. Mortality and long-term quality of life after percutaneous tracheotomy in Intensive Care Unit: a prospective observational study. Minerva Anestesiol 2018 Jan 16. DOI: 10.23736/S0375-9393.18.12133-X

Corresponding author e-mail

vargas.maria82@gmail.com