超越医院出院：创伤性损伤老年患者气管造口术后的一年死亡率
Looking Beyond Hospital Discharge: One-Year Mortality Following Tracheostomy Creation in Traumatically Injured Older Adults.
作者信息
Kregel Heather R, Van Gent Jan-Michael, Sunez Fatimah, Wandling Michael W, Mueck Krislynn M, Cotton Bryan A, Meyer David E, Moore Laura J, Kao Lillian S, Puzio Thaddeus J
机构信息
Division of Acute Care Surgery, Department of Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Surgical Trials and Evidence-based Practice (CSTEP), McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Translational Injury Research, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas.
Division of Acute Care Surgery, Department of Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas.
出版信息
J Surg Res. 2025 Sep;313:171-176. doi: 10.1016/j.jss.2025.05.028. Epub 2025 Jul 15.
INTRODUCTION
We aimed to evaluate long-term outcomes following tracheostomy in older trauma patients and hypothesized that 1-year survival decreases with older age.
METHODS
This was a descriptive analysis of intensive care unit patients ≥65 y old who underwent tracheostomy from 2015 to 2020. The National Death Index was accessed to determine time from tracheostomy creation to death. Groups were categorized by age. The primary outcome was 1-year mortality. Survival by age strata was analyzed using the Kaplan-Meier method.
RESULTS
Of 205 eligible patients, 125 (61%) were 65-74, 68 (33%) were 75-84, and 12 (6%) were >85 y old. Median injury severity scores and Charlson Comorbidity Index were similar between groups. One-year mortality increased by decade of life and median survival decreased by decade.
CONCLUSIONS
In this cohort, 58% died within 1 year of tracheostomy, and increasing age was associated with shorter survival. Clear goals and expectations are needed when advising patients and families regarding tracheostomy.
引言
我们旨在评估老年创伤患者气管切开术后的长期预后，并假设1年生存率会随着年龄增长而降低。
方法
这是一项对2015年至2020年期间在重症监护病房接受气管切开术的65岁及以上患者的描述性分析。通过国家死亡指数来确定从气管切开术至死亡的时间。根据年龄对患者进行分组。主要结局指标为1年死亡率。采用Kaplan-Meier法分析各年龄层的生存率。
结果
在205例符合条件的患者中，125例（61%）年龄在65至74岁之间，68例（33%）年龄在75至84岁之间，12例（6%）年龄超过85岁。各组间的损伤严重程度评分中位数和Charlson合并症指数相似。1年死亡率随年龄每增长十岁而升高，中位生存期随年龄每增长十岁而缩短。
结论
在该队列中，58%的患者在气管切开术后1年内死亡，年龄增长与生存期缩短相关。在就气管切开术向患者及其家属提供建议时，需要明确目标和预期。
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