Predictive factors for death and long-term outcomes in elderly critically ill patients following tracheotomy: a retrospective analysis.

OBJECTIVE

To explore the factors influencing death in elderly critically ill patients within 3 months and 6 months after tracheotomy and to discuss the long-term quality of life of patients and the burden on caregivers by disease type.

METHODS

This retrospective study included 160 elderly patients with tracheostomies. The study aimed to analyze the risk factors associated with mortality at 3 and 6 months post-tracheotomy using both single-factor analysis and multifactor logistic regression. The subjects were categorized into three groups based on the type of disease. Kaplan-Meier survival curves and log-rank tests were utilized to assess differences in survival rates among these groups. Furthermore, the Personal Activities of Daily Living (PADL) scale, the SF- 12 scale, and the Zarit Burden Interview (ZBI) were administered to analyze and compare the quality of life among the patients.

RESULTS

The PSI score (95% CI: 1.008-1.036), total dose of vasoactive drugs (95% CI: 1.001-1.007), and the number of medical consultations (95% CI: 0.418-0.929,) were identified as independent risk factors for mortality within three months following tracheotomy in elderly patients. Additionally, the PSI score (95% CI: 1.001-1.026, P < 0.05) and the total dose of vasoactive drugs (95% CI: 1.001-1.007, P < 0.05) were also independent risk factors for patient death within six months. No significant differences were observed in the survival rates among the three subgroups followed up for six months, significant differences were noted in the PADL, ZBI, and SF- 12 scores among these subgroups.

CONCLUSION

The quality of life and risk factors for mortality within six months following tracheotomy in critically ill elderly patients warrant careful consideration. Caregivers face varying challenges due to different underlying conditions, particularly in cases involving severe pneumonia and cardiac insufficiency, which require increased social awareness.