为了为危重病患者的共同决策提供信息，我们将进行一个回顾性的流行病学队列研究，以定义气管造口后的医疗轨迹。使用加利福尼亚州患者出院数据库（2018-2019）。这项研究包括接受气管造口手术的患者。本研究没有排除因素。我们追踪了气管造口后的1年结果，包括生存率和在医疗机构（HCF）内外的存活时间。根据患者的手术情况（是否需要重大手术室手术）、年龄（65岁或以上和65岁以下）、ICU前合并症（虚弱、慢性器官功能障碍、癌症和强壮度）以及气管造口入院期间是否需要透析进行了分层。我们确定了在研究期间接受气管造口的4,274名非手术成年人，其中50.9％年龄在65岁或以上。在65岁或以上的成年人中，气管造口后的中位生存期在虚弱、慢性器官功能障碍、癌症或透析患者中少于3个月。在年龄低于65岁的成年人中，癌症或透析患者气管造口后的中位生存期为3个月。大多数患者在气管造口后的前3个月在HCF中度过了大部分生命时间。年长的成年人在气管造口后的前3个月很少有在HCF之外度过的生命天数。在气管造口后的第一年，大多数最终死亡的患者几乎在HCF中度过了所有的生命时间。气管造口后的累积死亡率和中位生存期在大多数年龄段和人群中都非常低。年长的成年人和年轻成年人的某些亚群体在住院时间长，而在HCF之外的存活天数很少。这些信息可能帮助一些患者、替代者和医务人员做出决策。 © 2023 Society of Critical Care Medicine and Wolters Kluwer Health，Inc. 版权所有。

To define healthcare trajectories after tracheostomy to inform shared decision-making efforts for critically ill patients.Retrospective epidemiologic cohort study.California Patient Discharge Database 2018-2019.Patients who received a tracheostomy.None.We tracked 1-year outcomes after tracheostomy, including survival and time alive in and out of a healthcare facility (HCF. Patients were stratified based on surgical status (did the patient require a major operating room procedure or not), age (65 yr old or older and less than 65 yr), pre-ICU comorbid states (frailty, chronic organ dysfunction, cancer, and robustness), and the need for dialysis during the tracheostomy admission. We identified 4,274 nonsurgical adults who received a tracheostomy during the study period with 50.9% being 65 years old or older. Among adults 65 years old or older, median survival after tracheostomy was less than 3 months for individuals with frailty, chronic organ dysfunction, cancer, or dialysis. Median survival was 3 months for adults younger than 65 years with cancer or dialysis. Most patients spent the majority of days alive after a tracheostomy in an HCF in the first 3 months. Older adults had very few days alive and out of an HCF in the first 3 months after tracheostomy. Most patients who ultimately died in the first year after tracheostomy spent almost all days alive in an HCF.Cumulative mortality and median survival after a tracheostomy were very poor across most ages and groups. Older adults and several subgroups of younger adults experienced high rates of prolonged hospitalization with few days alive and out of an HCF. This information may aid some patients, surrogates, and providers in decision-making.Copyright © 2023 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.