Abstract
Objectives: To describe the short-term and long-term outcomes of tracheostomized Intensive Care Unit (ICU) patients and to identify any predictors of complications during and after the tracheostomy procedure.
Design: A retrospective and prospective, observational case series performed in a general medical-surgical adult ICU in a regional hospital in Hong Kong.
Results: A total of 153 patients were recruited. The most common indication for tracheostomy was prolonged mechanical ventilation (72.6%), followed by failure of extubation (15%). Surgical tracheostomy was the predominant method used (73.9%). There were no statistically significant differences between surgical and percutaneous tracheostomy on the complication rate. Minor bleeding was the most common short-term complication (10.5%) and tracheal stenosis was the most common long-term complication (5.1%). Hypertension (adjusted odds ratio 5.28, 95% CI 1.05-26.51, p=0.044) and chronic renal failure (CRF) (adjusted odds ratio 17.56, 95% CI 2.87-107.42, p=0.002) were independent risk factors for minor bleeding; while the need to reintubate within 48 hours after extubation (adjusted odds ratio 10.5, 95% CI 1.30-84.88, p=0.027) was an independent risk factor for tracheal stenosis. CRF was independently associated with composite complications (minor bleeding and tracheal stenosis; adjusted odds ratio 13.63, 95% CI of 2.47-75.16, p=0.003). Mental health score at 1 year or more was generally better than physical health score in this cohort of patients.
Conclusion: This study described the outcome, complications with associated predictors in tracheostomized ICU patients in Chinese population. Further larger trials are required to confirm the findings.
Chang Li Li, Lau Chun Wing, Lam Sin Man, Shum Hoi Ping, Chan King Chung Kenny, Yan Wing Wa
