title: Outcome after tracheostomy for respiratory failure in the elderly.
abstract: The purpose of this study was to determine hospital and postdischarge survival and functional status at follow-up in elderly patients receiving tracheostomy for respiratory failure and to determine if these outcomes differed between the younger elderly (65-74 years) and the older elderly (> or = 75 years). This was a retrospective chart review with prospective administration of the SF-36 conducted in 228 patients aged 65 years or older who had undergone tracheostomy to facilitate mechanical ventilation for respiratory failure at a tertiary care, university-affiliated, urban medical center. Demographics, comorbidities, hospital survival, liberation from mechanical ventilation, long-term survival, and functional status were determined. Combined hospital and hospice mortality did not differ by age, being 34% and 26% in the 65- to 74-year and > or = 75-year groups, respectively (P> .05). However, older patients (> or = 75 years old) were more likely to be discharged still requiring mechanical ventilation (62% vs 45%, P< .05). Only one half of hospital survivors survived for 1 additional year. Those discharged ventilator-dependent were more likely to die. Of the 20 participants in the SF-36 portion of the study, most had fair to good emotional and social functioning but were extremely limited physically.
authors.affiliation: Department of Anesthesiology, St. Vincent Mercy Medical Center, Toledo, Ohio 43617, USA. engoren@pol.net
authors.forename: Milo C
authors.initials: MC
authors.lastname: Engoren
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Arslanian-Engoren
mesh_terms: D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D013997:Time Factors; D014139:Tracheostomy; D016896:Treatment Outcome