Journal of palliative medicine · 2025
Tracheostomy Outcomes in Muslim Intensive Care Unit Patients with Acute Respiratory Failure: Highlighting a Critical Palliative Care Gap.
СтатьяНазвание и аннотация: Перевод в очереди
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Khalid Imran, Imran Manahil, Imran Raafey, Akhtar Muhammad Ali, Khalid Tabindeh Jabeen, Imran Maryam, Salman Anam, Imran Ibrahim, Salman Ibrahim, Shirazi Muhammad Usman, Khateeb Faisal, Ali Syed Saqib, All Coauthors,
Аннотация
BACKGROUND: Tracheostomy often marks the onset of prolonged critical illness with high mortality, yet outcome data from Muslim-majority settings are unavailable.
METHODS: We conducted a retrospective cohort study (2019-2023) of Muslim intensive care unit (ICU) patients undergoing tracheostomy for acute respiratory failure. The primary outcome was in-hospital mortality; secondary outcomes included ICU mortality, code-status transitions, and one-year survival.
RESULTS: Among 411 patients (median age 68 years; 55% male), 68% were hospice-eligible at admission, while 38% were bedridden. In-hospital mortality was 53%; one-year mortality, 68%. Although 90% were full code pre-tracheostomy, 77% transitioned to Do Not Attempt Resuscitation afterward. Palliative care consultation occurred in only 12%. Key mortality predictors included age, comorbidity burden, bedridden status, and receipt of cardiopulmonary resuscitation.
CONCLUSIONS: This study highlights three critical gaps in Muslim patients undergoing tracheostomy: high mortality, delayed code transitions, and inadequate palliative care before and during hospitalization. Future research should focus on strategies to bridge these palliative gaps.
METHODS: We conducted a retrospective cohort study (2019-2023) of Muslim intensive care unit (ICU) patients undergoing tracheostomy for acute respiratory failure. The primary outcome was in-hospital mortality; secondary outcomes included ICU mortality, code-status transitions, and one-year survival.
RESULTS: Among 411 patients (median age 68 years; 55% male), 68% were hospice-eligible at admission, while 38% were bedridden. In-hospital mortality was 53%; one-year mortality, 68%. Although 90% were full code pre-tracheostomy, 77% transitioned to Do Not Attempt Resuscitation afterward. Palliative care consultation occurred in only 12%. Key mortality predictors included age, comorbidity burden, bedridden status, and receipt of cardiopulmonary resuscitation.
CONCLUSIONS: This study highlights three critical gaps in Muslim patients undergoing tracheostomy: high mortality, delayed code transitions, and inadequate palliative care before and during hospitalization. Future research should focus on strategies to bridge these palliative gaps.