title: Predictors of short-term mortality in patients undergoing percutaneous dilatational tracheostomy.
abstract: OBJECTIVE
  The purpose of the study was to identify the predictors of short-term mortality in patients undergoing percutaneous dilatational tracheostomy (PDT).
  
  
  METHODS
  Retrospective analysis of data pertaining to adult patients who underwent PDT between July 2005 and June 2008 in an urban, academic, tertiary care medical center was done. Clinical and demographic data were analyzed for 483 patients undergoing PDT via multivariate logistic regression.
  
  
  RESULTS
  Mortality data were examined at in-hospital, 14, 30, and 180 days postprocedure. Overall mortality rates were 11% at 14 days, 19% at 30 days, and 40% at 180 days. In-hospital mortality was 30%.
  
  
  CONCLUSIONS
  Patients undergoing PDT have significant short-term mortality with 11% dying within 14 days and an in-hospital mortality rate of 30%. We identified an index diagnosis of ventilator-associated pneumonia and trauma to be associated with a higher survival rate, whereas older age, oncological diagnosis, cardiogenic shock, and ventricular-assist devices were associated with higher mortality. There is significant heterogeneity in both underlying diagnosis and patient outcomes, and these factors should be considered when deciding to perform this procedure and discussed with patients/family members to provide a realistic expectation of potential prognosis.
authors.affiliation: The Johns Hopkins Hospital, Baltimore, MD 21205, USA.
authors.forename: Vinciya
authors.initials: V
authors.lastname: Pandian
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Gilstrap
authors.forename: Marek A
authors.initials: MA
authors.lastname: Mirski
authors.forename: Elliott R
authors.initials: ER
authors.lastname: Haut
authors.forename: Adil H
authors.initials: AH
authors.lastname: Haider
authors.forename: David T
authors.initials: DT
authors.lastname: Efron
authors.forename: Natalie M
authors.initials: NM
authors.lastname: Bowman
authors.forename: Lonny B
authors.initials: LB
authors.lastname: Yarmus
authors.forename: Nasir I
authors.initials: NI
authors.lastname: Bhatti
authors.forename: Kent A
authors.initials: KA
authors.lastname: Stevens
authors.forename: Ravi
authors.initials: R
authors.lastname: Vaswani
authors.forename: David
authors.initials: D
authors.lastname: Feller-Kopman
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D006305:Health Status Indicators; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D014139:Tracheostomy / Q000379:methods* / Q000401:mortality*; D055815:Young Adult