2Dokuz Eylül University, Faculty of Medicine, Department of Anesthesiology and Reanimation, İzmir, Turkey
3Ä°zmir City Hospital, Department of Internal Medicine, Division of Medical Oncology, Ä°zmir, Turkey
4Kırklareli Training and Research Hospital, Department of Internal Medicine, Division of Intensive Care, Kırklareli, Turkey
5Dokuz Eylül University, Faculty of Medicine, Department of Chest Diseases, Division of Intensive Care, İzmir, Turkey DOI : 10.29400/tjgeri.2024.410 Introduction: The ongoing debate surrounding the early and long-term mortality of critically ill elderly patients who undergo tracheostomy remains unresolved.
Materials and Method: The primary aim of this retrospective study is to define independent factors for 90-day mortality in critically ill elderly patients who underwent tracheostomy during their intensive care unit stays between November 1, 2010, and October 31, 2020, in an academic tertiary hospital. The data were analyzed using the Mann-Whitney U, chi-square, and Fisher"s exact tests. Logistic regression analysis was performed to identify independent factors associated with 90-day mortality.
Results: A total of 585 elderly patients were included in the study. The 90- day mortality rate was 77.6%, which increased to 89.2% in one year. Vasopressor requirement (odds ratio [OR], 2.61; 95% confidence interval [CI], 1.46?4.57; p=0.001), hospital stay prior to intensive care unit admission >14 days (OR, 2.09; 95% CI, 1.18?3.68; p=0.011), occurrence of one or more periprocedural complications of tracheostomy procedure (OR, 2.27; 95% CI, 1.07?4.82; p=0.033), and patients with a Charlson comorbidity index ?6 (OR, 1.57; 95% CI, 1.03?2.40; p=0.037) were identified as independent factors for 90-day mortality in critically ill elderly patients.
Conclusions: Elderly patients with respiratory failure who undergo tracheostomy procedures frequently require prolonged, complex care during hospitalization and after discharge. Further research is essential to develop predictive models for early and long-term mortality risk and to establish benchmarks for the quality of post-discharge care.
Keywords : Critical Care; Aged; Morbidity: Mortality; Tracheostomy