Fatih Şahin, Burcu Can, Havva Kocayiğit, Burak Kaya, Ali Fuat Erdem
Anestezi Dergisi - 2025;33(4):277-283
Objective: Advances in intensive care medicine have significantly reduced mortality rates, contributing to an increased elderly population. Consequently, the number of chronically critically ill patients dependent on medical devices is rising, resulting in prolonged hospital stays. This study aimed to evaluate the intensive care unit (ICU) stay and discharge outcomes of chronically critically ill patients dependent on medical devices. Method: This retrospective study included chronically critically ill patients monitored in a tertiary-level anesthesia ICU between January 2019 and January 2024, all of whom underwent tracheostomy and were provided with home mechanical ventilators. Data collected from the hospital information system included admission reasons, comorbidities, APACHE II scores, timing of tracheostomy and percutaneous endoscopic gastrostomy (PEG). Patients were categorized into two groups: discharged (Group 1) and deceased (Group 2). Results: Of the 190 eligible patients, 108 (57%) were discharged while 82 (43%) died. Respiratory failure was the most common admission diagnosis in both groups. Trauma-related admissions differed significantly between the groups. Neurological disorders were the most prevalent comorbidity in Group 1, whereas hypertension was most common in Group 2. Pulmonary disease and malignancy were significantly more frequent in Group 2. No significant difference was observed in the duration to medical device provision, or the timing of tracheostomy and PEG between groups. However, Group 2 showed significantly higher rates of blood product use and culture testing. Conclusion: Prolonged ICU stays among chronically critically ill, device-dependent patients increase healthcare costs, reduce ICU bed availability, and delay access to critical care for other patients.
