TY - JOUR
T1 - Tracheostomy after cardiac surgery
T2 - Timing of tracheostomy as a risk factor for mortality
AU - Ben-Avi, Ronny
AU - Ben-Nun, Alon
AU - Levin, Shany
AU - Simansky, David
AU - Zeitlin, Nonna
AU - Sternik, Leonid
AU - Raanani, Ehud
AU - Kogan, Alexander
PY - 2014/6
Y1 - 2014/6
N2 - Objectives 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).
AB - Objectives 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).
KW - cardiac surgery
KW - intensive care unit
KW - mortality
KW - prolonged ventilation
KW - tracheostomy
UR - http://www.scopus.com/inward/record.url?scp=84902250815&partnerID=8YFLogxK
U2 - 10.1053/j.jvca.2013.10.031
DO - 10.1053/j.jvca.2013.10.031
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C2 - 24525162
AN - SCOPUS:84902250815
SN - 1053-0770
VL - 28
SP - 493
EP - 496
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
IS - 3
ER -