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. 2020 Jul 15;2(7):e0156.
doi: 10.1097/CCE.0000000000000156. eCollection 2020 Jul.

Tracheostomy and Gastrostomy in Geriatric Trauma Associated With High Postdischarge Mortality

Sherry M Boone  1 , Bryan R Collier  1   2 , Emily R Faulks  1   2 , Tonja M Locklear  3 , Katie L Bower  1   2 , Daniel I Lollar  1   2 , Nitasha Dhiman  2 , Michael S Nussbaum  1   2 , Mark E Hamill  1   2
Affiliations

Tracheostomy and Gastrostomy in Geriatric Trauma Associated With High Postdischarge Mortality

Sherry M Boone et al. Crit Care Explor. .

Abstract

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.

Keywords: gastrostomy; geriatrics; mortality; tracheostomy; trauma.

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Conflict of interest statement

The authors have disclosed that they do not have any potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Kaplan-Meier curves displaying the survival probability for adult and geriatric patients who underwent tracheostomy and/or gastrostomy tube placement after suffering traumatic injuries. Postdischarge mortality in the geriatric cohort was 63.2% (24/38) versus adults (10%, 7/69).
Figure 2.
Figure 2.
Kaplan-Meier curve displaying postdischarge survival probability of geriatric patients’ post-traumatic event undergoing tracheostomy and/or gastrostomy tube placement versus those not undergoing procedures. Twenty-four of the 38 geriatric patients with tubes died within 5 yr of discharge.
Figure 3.
Figure 3.
Kaplan-Meier curve displaying postdischarge survival probability of adult patients post-traumatic event undergoing tracheostomy and/or gastrostomy tube placement versus those not undergoing procedures. Seven out of the 76 adult patients with tubes died within the 5 yr postdischarge.
Figure 4.
Figure 4.
Kaplan-Meier curves for cumulative survival probability for all patients undergoing tracheostomy, gastrostomy, and versus tracheostomy and gastrostomy procedures. Mortality was highest in the gastrostomy cohort at 61.5% (16/26) when compared to tracheostomy 15.7% (11/70) or tracheostomy and gastrostomy 22.2% (4/18) cohorts.
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