An Outcome Analysis of Mechanically Ventilated Middle Aged and Elderly Taiwanese Patients Undergoing Tracheostomy

SummaryBackgroundThe primary goal in critically ill patients who are mechanically ventilated is to wean from the ventilator. Higher weaning rates have been noted in patients undergoing mechanical ventilation following tracheostomy. The purpose of this study was to clarify the current status of tracheostomy execution in mechanically ventilated middle-aged and elderly patients.MethodsPatients admitted to the intensive care unit (ICU) aged ≥ 45 years, mechanically ventilated on at least one occasion after undergoing tracheostomy, were included by using hospitalization registration records that had been submitted to the Bureau of National Health Insurance between March 2004 and February 2009. We analyzed the current status of tracheostomy execution and the risk factors for mortality.ResultsWe enrolled a total of 453,939 patients ever using ventilators, with 29,128 of them (20,059 men and 9069 women) undergoing tracheostomies. The tracheostomy rate was 6.4% among patients who were mechanically ventilated. The mean age was 72 years. The mean RW value was 4.78. The mean ICU days, total hospital days, ventilator days, and mortality rate were highest in patients aged ≥ 75 years, followed by patients aged 65–74 years. The medical expenses were highest in patients aged 65–74 years, followed by those aged ≥ 75 years. The tracheostomy rate showed the strongest decline in patients aged ≥ 75 years, followed by patients aged 65–74 years. Sex, age, hospital level, the duration of mechanical ventilation, and medical and antibiotic expenses were identified as risk factors for mortality (p