Study of tracheostomized patients in Intensive Care Unit

Objectives: To describe the short-term and long-term outcomes of tracheostomized Intensive Care Unit (ICU) patients and to identify any predictors of complications during and after the tracheostomy procedure.
Design: A retrospective and prospective, observational case series performed in a general medical-surgical adult ICU in a regional hospital in Hong Kong.
Results: A total of 153 patients were recruited. The most common indication for tracheostomy was prolonged mechanical ventilation (72.6%), followed by failure of extubation (15%). Surgical tracheostomy was the predominant method used (73.9%). There were no statistically significant differences between surgical and percutaneous tracheostomy on the complication rate. Minor bleeding was the most common short-term complication (10.5%) and tracheal stenosis was the most common long-term complication (5.1%). Hypertension (adjusted odds ratio 5.28, 95% CI 1.05-26.51, p=0.044) and chronic renal failure (CRF) (adjusted odds ratio 17.56, 95% CI 2.87-107.42, p=0.002) were independent risk factors for minor bleeding; while the need to reintubate within 48 hours after extubation (adjusted odds ratio 10.5, 95% CI 1.30-84.88, p=0.027) was an independent risk factor for tracheal stenosis. CRF was independently associated with composite complications (minor bleeding and tracheal stenosis; adjusted odds ratio 13.63, 95% CI of 2.47-75.16, p=0.003). Mental health score at 1 year or more was generally better than physical health score in this cohort of patients.
Conclusion: This study described the outcome, complications with associated predictors in tracheostomized ICU patients in Chinese population. Further larger trials are required to confirm the findings.