title: Outcome of mechanically ventilated patients who require a tracheostomy.
abstract: OBJECTIVE
  To estimate the prevalence of, the risk factors associated with, and the outcome of tracheostomy in a heterogeneous population of mechanically ventilated patients.
  
  
  METHODS
  Prospective, observational cohort study.
  
  
  METHODS
  A total of 361 intensive care units from 12 countries.
  
  
  METHODS
  A cohort of 5,081 patients mechanically ventilated for >12 hrs.
  
  
  METHODS
  None.
  
  
  RESULTS
  A total of 546 patients (10.7%) had a tracheostomy during their stay in the intensive care unit. Tracheostomy was performed at a median time of 12 days (interquartile range, 7-17) from the beginning of mechanical ventilation. Variables associated with the performance of tracheostomy were duration of mechanical ventilation, need for reintubation, and neurologic disease as the primary reason of mechanical ventilation. The intensive care unit stay of patients with or without tracheostomy was a median of 21 days (interquartile range, 12-32) vs. 7 days (interquartile range, 4-12; p < .001), respectively, and the hospital stay was a median 36 days (interquartile range, 23-53) vs. 15 days (interquartile range, 8-26; p < .001), respectively. Adjusting by other variables, tracheostomy was independently related with survival in the intensive care unit (odds ratio, 2.22; 95% confidence interval, 1.72-2.86). Mortality in the hospital was similar in both groups (39% vs. 40%, p = .65).
  
  
  CONCLUSIONS
  Tracheostomy is a common surgical procedure in the intensive care unit that is associated with a lower mortality in the unit but with a longer stay and a similar mortality in the hospital than in patients without tracheostomy.
authors.affiliation: Hospital Universitario de Getafe, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Frutos-Vivar
authors.forename: Andrés
authors.initials: A
authors.lastname: Esteban
authors.forename: Carlos
authors.initials: C
authors.lastname: Apezteguía
authors.forename: Antonio
authors.initials: A
authors.lastname: Anzueto
authors.forename: Peter
authors.initials: P
authors.lastname: Nightingale
authors.forename: Marco
authors.initials: M
authors.lastname: González
authors.forename: Luis
authors.initials: L
authors.lastname: Soto
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodrigo
authors.forename: Jean
authors.initials: J
authors.lastname: Raad
authors.forename: Cide M
authors.initials: CM
authors.lastname: David
authors.forename: Dimitros
authors.initials: D
authors.lastname: Matamis
authors.forename: Gabriel
authors.initials: G
authors.lastname: D' Empaire
mesh_terms: D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009468:Neuromuscular Diseases / Q000628:therapy; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000628:therapy; D012307:Risk Factors; D014139:Tracheostomy / Q000009:adverse effects; D016896:Treatment Outcome