Impact of Physiotherapy and Rehabilitation on Mortality in Patients with Tracheostomies Post-Mechanical Ventilation

Tracheostomy is commonly performed in patients requiring prolonged mechanical ventilation, such as those with stroke, traumatic brain injury, or pneumonia, to facilitate respiratory care. These patients frequently experience complications and respiratory dysfunctions, highlighting the need for physiotherapy and rehabilitation. This study aimed to evaluate the impact of physiotherapy and rehabilitation on the mortality rate of post-tracheostomy patients. Prospective cohort study was conducted on 106 post-tracheostomy patients at the Rehabilitation and Occupational Disease Treatment Hospital from January to December 2023. Data collected included demographics, comorbidities, clinical symptoms, radiological findings, ventilation duration, and hospital stay. Multivariate logistic regression analysis was used to identify independent risk factors for in-hospital mortality. The median patient age was 47 years (IQR 30–68). The cohort was predominantly female (ratio 3.4:1). Common comorbidities included diabetes, hypertension, and chronic lung disease. Pneumonia was diagnosed in 81.1% of patients. The median time to tracheostomy was nine days, with a median hospital stay of 38.5 days. The overall mortality rate was 9.4%. Independent risk factors for mortality included age (OR 1.15, 95% CI 1.05–1.27, p = 0.004) and chest X-ray consolidation (OR 8.16, 95% CI 0.89–74.76, p = 0.063), while physiotherapy and rehabilitation were associated with reduced mortality (OR 0.017, 95% CI 0.001–0.51, p = 0.019). Older age and chest X-ray consolidation were independent risk factors for mortality, whereas physiotherapy and rehabilitation significantly reduced mortality risk, emphasizing their critical role in patient outcomes.