Tracheostomy and Gastrostomy in Geriatric Trauma Associated With High Postdischarge Mortality.

OBJECTIVES

Identify 5-year mortality rates in trauma patients greater than 18 years old who undergo tracheostomy and/or gastrostomy tube placement.

DESIGN

Retrospective convenience sample with two cohorts.

SETTING

Academic level 1 trauma center.

PATIENTS

Hospitalized patients admitted to the trauma service from July 2008 to December 2012 who underwent tracheostomy and/or gastrostomy tube placement.

INTERVENTIONS

Patients were placed into two cohorts: adult 18-64 and geriatric greater than or equal to 65; mortality data were obtained from the National Death Index.

MEASUREMENTS AND MAIN RESULTS

The primary outcome was 5-year mortality of both cohorts as well as those admitted who did not receive tracheostomy or gastrostomy. Univariate analysis was performed using Fisher exact and Wilcoxon signed-rank tests. Kaplan-Meier curves were plotted to examine mortality up to 5 years after discharge.

CONCLUSIONS

Five-year postdischarge mortality is significantly higher in geriatric patients undergoing tracheostomy and/or gastrostomy after traumatic injury. Fifty percent die within the first 28 weeks following discharge and 93% die within 2 years.