title: Tracheostomy after cardiac surgery: timing of tracheostomy as a risk factor for mortality.
abstract: OBJECTIVE
  The optimal timing for tracheostomy after cardiac surgery in patients undergoing prolonged ventilation is controversial. The aim of this study was to assess the effect of tracheostomy timing on short- and long-term mortality of these patients.
  
  
  METHODS
  Retrospective study of prospectively collected data.
  
  
  METHODS
  Cardiac surgical intensive care unit (ICU) in a tertiary-care, university-affiliated hospital.
  
  
  METHODS
  All patients undergoing tracheostomy after cardiac surgery between September 2004 and March 2013 were included.
  
  
  METHODS
  The authors compared the outcome in 2 groups of patients according to the timing of tracheostomy: Group I, early-intermediate tracheostomy (0-14 days) and Group II, late tracheostomy (≥15 days).
  
  
  RESULTS
  During the study period, 6,069 patients underwent cardiac surgery; among them, 199 patients (3.26%) received a tracheostomy. There were 90 patients in Group I and 109 patients in Group II. There was no significant difference in the severity of the patients' illness between the groups. The mortality rate at 3 months, 6 months, 1 year, and 2 years was 37%, 48%, 56%, and 58% in Group I, respectively, and 58%, 70%, 74%, and 77% in Group II, respectively (p< 0.01).
  
  
  CONCLUSIONS
  Early-intermediate (0-14 days) tracheostomy after cardiac surgery in patients requiring prolonged mechanical ventilation was associated with reduced mortality compared with late tracheostomy (≥15 days).
authors: Department of Thoracic Surgery, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Ronny
authors: R
authors: Ben-Avi
authors: Department of Thoracic Surgery, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Alon
authors: A
authors: Ben-Nun
authors: Department of Cardiac Surgery, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Shany
authors: S
authors: Levin
authors: Department of Thoracic Surgery, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: David
authors: D
authors: Simansky
authors: Department of Thoracic Surgery, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Nonna
authors: N
authors: Zeitlin
authors: Department of Cardiac Surgery, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Leonid
authors: L
authors: Sternik
authors: Department of Cardiac Surgery, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Ehud
authors: E
authors: Raanani
authors: Department of Cardiac Surgery, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: alexanderkogan140@hotmail.com.
authors: Alexander
authors: A
authors: Kogan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000379:methods* / Q000401:mortality*; D002315:Cardiopulmonary Bypass; D003422:Critical Care; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D014139:Tracheostomy / Q000401:mortality*
keywords: cardiac surgery; intensive care unit; mortality; prolonged ventilation; tracheostomy