title: Long-term survival in patients with tracheostomy and prolonged mechanical ventilation in Olmsted County, Minnesota.
abstract: BACKGROUND
  An increasing number of patients require prolonged mechanical ventilation (PMV), which is associated with high morbidity and poor long-term survival, but there are few data regarding the incidence and outcome of PMV patients from a community perspective.
  
  
  METHODS
  We retrospectively  reviewed the electronic medical records of adult Olmsted county, Minnesota, residents admitted to the intensive care units at the 2 Mayo Clinic Rochester hospitals from January 1, 2003, to December 31, 2007, who underwent tracheostomy for PMV.
  
  
  RESULTS
  Sixty-five patients, median age 68 years  (interquartile range [IQR] 49-80 y), 39 male, underwent tracheostomy for PMV, resulting in an age-adjusted incidence of 13 (95% CI 10-17) per 100,000 patient-years at risk. The median number of days on mechanical ventilation was 24 days (IQR 18-37 d). Forty-six patients  (71%) survived to hospital discharge, and 36 (55%) were alive at 1-year follow-up. After adjusting for age and baseline severity of illness, the presence of COPD was independently associated with 1-year mortality (hazard ratio 3.4, 95% CI 1.4-8.2%).
  
  
  CONCLUSIONS
  There was a considerable  incidence of tracheostomy for PMV. The presence of COPD was an independent predictor of 1-year mortality.
authors: Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA.
authors: Marija
authors: M
authors: Kojicic
authors: Guangxi
authors: G
authors: Li
authors: Adil
authors: A
authors: Ahmed
authors: Lokendra
authors: L
authors: Thakur
authors: Cesar
authors: C
authors: Trillo-Alvarez
authors: Rodrigo
authors: R
authors: Cartin-Ceba
authors: Peter C
authors: PC
authors: Gay
authors: Ognjen
authors: O
authors: Gajic
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