A Frailty Index Identifies Patients at High Risk of Mortality after Tracheostomy
Objective To evaluate the utility of a modified frailty index as an indicator of postoperative mortality in patients undergoing tracheostomy. Study Design Case series with chart review. Setting Tertiary care veterans hospital. Subjects and Methods A chart review was conducted of consecutive tracheos...
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Veröffentlicht in: | Otolaryngology-head and neck surgery 2014-04, Vol.150 (4), p.568-573 |
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creator | Johnson, Matthew S. Bailey, Travis L. Schmid, Kendra K. Lydiatt, William M. Johanning, Jason M. |
description | Objective
To evaluate the utility of a modified frailty index as an indicator of postoperative mortality in patients undergoing tracheostomy.
Study Design
Case series with chart review.
Setting
Tertiary care veterans hospital.
Subjects and Methods
A chart review was conducted of consecutive tracheostomies performed between April 2007 and September 2012. A modified frailty index consisting of 11 items based on the Revised Minimum Data Set Mortality Rating Index (MMRI-R) was retrospectively applied using the patient’s status immediately prior to tracheostomy. The resultant 6-month calculated mortality risk was compared with both the Veterans Health Administration Surgical Quality Improvement Program’s (VASQIP) 30-day calculated mortality and actual mortality.
Results
One hundred consecutive tracheostomies were analyzed. No patients were excluded. Sixty-nine patients died within the study period, with 1-, 6-, and 12-month mortality rates of 25%, 43%, and 59%, respectively. The average calculated 6-month mortality risk using the modified frailty index was 40.5% for nonsurvivors compared with 25.4% for survivors (P = .001). Both the VASQIP calculator and modified frailty index differentiated mortality risks between patients without head and neck cancer who survived less than 6 months versus those who survived longer than 6 months (P = .006 and .01). However, neither the VASQIP nor the modified frailty index differentiated mortality risks for head and neck cancer patients who survived less than 6 months versus greater than 6 months (P = .94 and .26).
Conclusion
A modified frailty index identifies patients without head and neck cancer at high risk of postoperative mortality after tracheostomy. |
doi_str_mv | 10.1177/0194599813519749 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1512559842</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0194599813519749</sage_id><sourcerecordid>1512559842</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3869-aff4c90dc3eafec961695d5b3ba6031ac23f9013eaea8b393aa666aa93b8168a3</originalsourceid><addsrcrecordid>eNqFkc9LwzAUx4Mobv64e5IcvVSTJk2b4xzODaYbMs_ltU22zHadSYv2v7el04Mgnh6P7w8en4fQFSW3lIbhHaGSB1JGlAVUhlweoSElMvRERMNjNOxkr9MH6My5LSFEiDA8RQOfcya44EO0HOGJBZNXDZ7tMvWJZ5naVUYb5fASKtMuDkOFp2a9wS_GveFS46fSVpCbNgO6UhavLKQbVbqqLJoLdKIhd-ryMM_R6-RhNZ5688XjbDyaeymLhPRAa55KkqVMgVapFFTIIAsSloAgjELqMy0JbVUFUcIkAxBCAEiWRFREwM7RTd-7t-V7rVwVF8alKs9hp8raxTSgfhDIiPutlfTW1JbOWaXjvTUF2CamJO44xr85tpHrQ3udFCr7CXyDaw1Rb_gwuWr-LYwX0-f7Sfsb2nV7fdTBWsXbsra7FtTft3wBLhSKaw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1512559842</pqid></control><display><type>article</type><title>A Frailty Index Identifies Patients at High Risk of Mortality after Tracheostomy</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>SAGE Complete A-Z List</source><creator>Johnson, Matthew S. ; Bailey, Travis L. ; Schmid, Kendra K. ; Lydiatt, William M. ; Johanning, Jason M.</creator><creatorcontrib>Johnson, Matthew S. ; Bailey, Travis L. ; Schmid, Kendra K. ; Lydiatt, William M. ; Johanning, Jason M.</creatorcontrib><description>Objective
To evaluate the utility of a modified frailty index as an indicator of postoperative mortality in patients undergoing tracheostomy.
Study Design
Case series with chart review.
Setting
Tertiary care veterans hospital.
Subjects and Methods
A chart review was conducted of consecutive tracheostomies performed between April 2007 and September 2012. A modified frailty index consisting of 11 items based on the Revised Minimum Data Set Mortality Rating Index (MMRI-R) was retrospectively applied using the patient’s status immediately prior to tracheostomy. The resultant 6-month calculated mortality risk was compared with both the Veterans Health Administration Surgical Quality Improvement Program’s (VASQIP) 30-day calculated mortality and actual mortality.
Results
One hundred consecutive tracheostomies were analyzed. No patients were excluded. Sixty-nine patients died within the study period, with 1-, 6-, and 12-month mortality rates of 25%, 43%, and 59%, respectively. The average calculated 6-month mortality risk using the modified frailty index was 40.5% for nonsurvivors compared with 25.4% for survivors (P = .001). Both the VASQIP calculator and modified frailty index differentiated mortality risks between patients without head and neck cancer who survived less than 6 months versus those who survived longer than 6 months (P = .006 and .01). However, neither the VASQIP nor the modified frailty index differentiated mortality risks for head and neck cancer patients who survived less than 6 months versus greater than 6 months (P = .94 and .26).
Conclusion
A modified frailty index identifies patients without head and neck cancer at high risk of postoperative mortality after tracheostomy.</description><identifier>ISSN: 0194-5998</identifier><identifier>EISSN: 1097-6817</identifier><identifier>DOI: 10.1177/0194599813519749</identifier><identifier>PMID: 24436464</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Airway Obstruction - pathology ; Airway Obstruction - surgery ; Cause of Death ; Cohort Studies ; Databases, Factual ; Follow-Up Studies ; Frail Elderly ; frailty ; Head and Neck Neoplasms - pathology ; Head and Neck Neoplasms - surgery ; Hospital Mortality - trends ; Hospitals, Veterans ; Humans ; Male ; Middle Aged ; mortality ; Pilot Projects ; Postoperative Complications - mortality ; Preoperative Care - methods ; Retrospective Studies ; Risk Assessment ; risk calculator ; Severity of Illness Index ; Survival Analysis ; Time Factors ; tracheostomy ; Tracheostomy - methods ; Tracheostomy - mortality ; VASQIP</subject><ispartof>Otolaryngology-head and neck surgery, 2014-04, Vol.150 (4), p.568-573</ispartof><rights>American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014</rights><rights>2014 American Association of Otolaryngology‐Head and Neck Surgery Foundation (AAO‐HNSF)</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3869-aff4c90dc3eafec961695d5b3ba6031ac23f9013eaea8b393aa666aa93b8168a3</citedby><cites>FETCH-LOGICAL-c3869-aff4c90dc3eafec961695d5b3ba6031ac23f9013eaea8b393aa666aa93b8168a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0194599813519749$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0194599813519749$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,777,781,1412,21800,27905,27906,43602,43603,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24436464$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Johnson, Matthew S.</creatorcontrib><creatorcontrib>Bailey, Travis L.</creatorcontrib><creatorcontrib>Schmid, Kendra K.</creatorcontrib><creatorcontrib>Lydiatt, William M.</creatorcontrib><creatorcontrib>Johanning, Jason M.</creatorcontrib><title>A Frailty Index Identifies Patients at High Risk of Mortality after Tracheostomy</title><title>Otolaryngology-head and neck surgery</title><addtitle>Otolaryngol Head Neck Surg</addtitle><description>Objective
To evaluate the utility of a modified frailty index as an indicator of postoperative mortality in patients undergoing tracheostomy.
Study Design
Case series with chart review.
Setting
Tertiary care veterans hospital.
Subjects and Methods
A chart review was conducted of consecutive tracheostomies performed between April 2007 and September 2012. A modified frailty index consisting of 11 items based on the Revised Minimum Data Set Mortality Rating Index (MMRI-R) was retrospectively applied using the patient’s status immediately prior to tracheostomy. The resultant 6-month calculated mortality risk was compared with both the Veterans Health Administration Surgical Quality Improvement Program’s (VASQIP) 30-day calculated mortality and actual mortality.
Results
One hundred consecutive tracheostomies were analyzed. No patients were excluded. Sixty-nine patients died within the study period, with 1-, 6-, and 12-month mortality rates of 25%, 43%, and 59%, respectively. The average calculated 6-month mortality risk using the modified frailty index was 40.5% for nonsurvivors compared with 25.4% for survivors (P = .001). Both the VASQIP calculator and modified frailty index differentiated mortality risks between patients without head and neck cancer who survived less than 6 months versus those who survived longer than 6 months (P = .006 and .01). However, neither the VASQIP nor the modified frailty index differentiated mortality risks for head and neck cancer patients who survived less than 6 months versus greater than 6 months (P = .94 and .26).
Conclusion
A modified frailty index identifies patients without head and neck cancer at high risk of postoperative mortality after tracheostomy.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Airway Obstruction - pathology</subject><subject>Airway Obstruction - surgery</subject><subject>Cause of Death</subject><subject>Cohort Studies</subject><subject>Databases, Factual</subject><subject>Follow-Up Studies</subject><subject>Frail Elderly</subject><subject>frailty</subject><subject>Head and Neck Neoplasms - pathology</subject><subject>Head and Neck Neoplasms - surgery</subject><subject>Hospital Mortality - trends</subject><subject>Hospitals, Veterans</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>mortality</subject><subject>Pilot Projects</subject><subject>Postoperative Complications - mortality</subject><subject>Preoperative Care - methods</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>risk calculator</subject><subject>Severity of Illness Index</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><subject>tracheostomy</subject><subject>Tracheostomy - methods</subject><subject>Tracheostomy - mortality</subject><subject>VASQIP</subject><issn>0194-5998</issn><issn>1097-6817</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc9LwzAUx4Mobv64e5IcvVSTJk2b4xzODaYbMs_ltU22zHadSYv2v7el04Mgnh6P7w8en4fQFSW3lIbhHaGSB1JGlAVUhlweoSElMvRERMNjNOxkr9MH6My5LSFEiDA8RQOfcya44EO0HOGJBZNXDZ7tMvWJZ5naVUYb5fASKtMuDkOFp2a9wS_GveFS46fSVpCbNgO6UhavLKQbVbqqLJoLdKIhd-ryMM_R6-RhNZ5688XjbDyaeymLhPRAa55KkqVMgVapFFTIIAsSloAgjELqMy0JbVUFUcIkAxBCAEiWRFREwM7RTd-7t-V7rVwVF8alKs9hp8raxTSgfhDIiPutlfTW1JbOWaXjvTUF2CamJO44xr85tpHrQ3udFCr7CXyDaw1Rb_gwuWr-LYwX0-f7Sfsb2nV7fdTBWsXbsra7FtTft3wBLhSKaw</recordid><startdate>201404</startdate><enddate>201404</enddate><creator>Johnson, Matthew S.</creator><creator>Bailey, Travis L.</creator><creator>Schmid, Kendra K.</creator><creator>Lydiatt, William M.</creator><creator>Johanning, Jason M.</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201404</creationdate><title>A Frailty Index Identifies Patients at High Risk of Mortality after Tracheostomy</title><author>Johnson, Matthew S. ; Bailey, Travis L. ; Schmid, Kendra K. ; Lydiatt, William M. ; Johanning, Jason M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3869-aff4c90dc3eafec961695d5b3ba6031ac23f9013eaea8b393aa666aa93b8168a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Airway Obstruction - pathology</topic><topic>Airway Obstruction - surgery</topic><topic>Cause of Death</topic><topic>Cohort Studies</topic><topic>Databases, Factual</topic><topic>Follow-Up Studies</topic><topic>Frail Elderly</topic><topic>frailty</topic><topic>Head and Neck Neoplasms - pathology</topic><topic>Head and Neck Neoplasms - surgery</topic><topic>Hospital Mortality - trends</topic><topic>Hospitals, Veterans</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>mortality</topic><topic>Pilot Projects</topic><topic>Postoperative Complications - mortality</topic><topic>Preoperative Care - methods</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>risk calculator</topic><topic>Severity of Illness Index</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><topic>tracheostomy</topic><topic>Tracheostomy - methods</topic><topic>Tracheostomy - mortality</topic><topic>VASQIP</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Johnson, Matthew S.</creatorcontrib><creatorcontrib>Bailey, Travis L.</creatorcontrib><creatorcontrib>Schmid, Kendra K.</creatorcontrib><creatorcontrib>Lydiatt, William M.</creatorcontrib><creatorcontrib>Johanning, Jason M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Otolaryngology-head and neck surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Johnson, Matthew S.</au><au>Bailey, Travis L.</au><au>Schmid, Kendra K.</au><au>Lydiatt, William M.</au><au>Johanning, Jason M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Frailty Index Identifies Patients at High Risk of Mortality after Tracheostomy</atitle><jtitle>Otolaryngology-head and neck surgery</jtitle><addtitle>Otolaryngol Head Neck Surg</addtitle><date>2014-04</date><risdate>2014</risdate><volume>150</volume><issue>4</issue><spage>568</spage><epage>573</epage><pages>568-573</pages><issn>0194-5998</issn><eissn>1097-6817</eissn><abstract>Objective
To evaluate the utility of a modified frailty index as an indicator of postoperative mortality in patients undergoing tracheostomy.
Study Design
Case series with chart review.
Setting
Tertiary care veterans hospital.
Subjects and Methods
A chart review was conducted of consecutive tracheostomies performed between April 2007 and September 2012. A modified frailty index consisting of 11 items based on the Revised Minimum Data Set Mortality Rating Index (MMRI-R) was retrospectively applied using the patient’s status immediately prior to tracheostomy. The resultant 6-month calculated mortality risk was compared with both the Veterans Health Administration Surgical Quality Improvement Program’s (VASQIP) 30-day calculated mortality and actual mortality.
Results
One hundred consecutive tracheostomies were analyzed. No patients were excluded. Sixty-nine patients died within the study period, with 1-, 6-, and 12-month mortality rates of 25%, 43%, and 59%, respectively. The average calculated 6-month mortality risk using the modified frailty index was 40.5% for nonsurvivors compared with 25.4% for survivors (P = .001). Both the VASQIP calculator and modified frailty index differentiated mortality risks between patients without head and neck cancer who survived less than 6 months versus those who survived longer than 6 months (P = .006 and .01). However, neither the VASQIP nor the modified frailty index differentiated mortality risks for head and neck cancer patients who survived less than 6 months versus greater than 6 months (P = .94 and .26).
Conclusion
A modified frailty index identifies patients without head and neck cancer at high risk of postoperative mortality after tracheostomy.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>24436464</pmid><doi>10.1177/0194599813519749</doi><tpages>6</tpages></addata></record> |
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source | MEDLINE; Wiley Online Library Journals Frontfile Complete; SAGE Complete A-Z List |
subjects | Adult Aged Aged, 80 and over Airway Obstruction - pathology Airway Obstruction - surgery Cause of Death Cohort Studies Databases, Factual Follow-Up Studies Frail Elderly frailty Head and Neck Neoplasms - pathology Head and Neck Neoplasms - surgery Hospital Mortality - trends Hospitals, Veterans Humans Male Middle Aged mortality Pilot Projects Postoperative Complications - mortality Preoperative Care - methods Retrospective Studies Risk Assessment risk calculator Severity of Illness Index Survival Analysis Time Factors tracheostomy Tracheostomy - methods Tracheostomy - mortality VASQIP |
title | A Frailty Index Identifies Patients at High Risk of Mortality after Tracheostomy |
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