• Dominique Dundaru-Bandi, Linda M Zhu, Milana Schipper, Paul J Warshawsky, and Blair C Schwartz.
• Faculty of Medicine, McGill University, Montreal, QC, Canada.
• BMC Anesthesiol. 2025 Feb 3; 25 (1): 5454.

BackgroundThere is little research on long-term, patient-centered outcomes in critically ill patients undergoing tracheostomy for secretion management or prolonged ventilation. The goal of this study was to determine and compare hospital and long-term mortality, and incidence of new institutionalization amongst patients who underwent an ICU tracheostomy for these two aforementioned indications.MethodsThis was a single center historic cohort study of all ICU patients who received a tracheostomy for secretion management or prolonged ventilation from 2011 to 2022. We compared hospital and long-term mortality and incidence of new institutionalization between these two groups.ResultsA cohort of 247 patients (133 secretion management, 114 prolonged ventilation) was established. Overall hospital mortality was 86/247 (35%), mortality at 1 year was 106/207 (51%), and at 3 years was 117/167 (70%), with no significant difference between the two indications. Patients with prolonged ventilation indication had a significantly higher ICU mortality [34/114 (30%) vs. 13/133 (10%), P < 0.001]. Amongst hospital survivors, 49/137 (36%) were unable to return home, with significantly more patients tracheostomized for secretion management requiring new institutionalization [37/78 (47%) vs. 12/59 (20%), P = 0.002].ConclusionsTracheostomy indication may be an important determinant of short- and long-term patient-centered outcomes. Patients receiving a tracheostomy for secretion management were twice as likely to be discharged to a new institution compared to prolonged ventilation patients. Patient-centered outcomes should be included in future studies and if confirmed, these outcomes should be incorporated into discussions about tracheostomy decision making.© 2025. The Author(s).

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