METHODS: Retrospective study of post-intubated patients with a tracheostomy seen for screening evaluation at a single long-term acute care hospital (LTACH) from 2019 to 2022.
RESULTS: Patients were followed for an average of 115 days after extubation. Forty-nine of 119 adult patients had ALgI. Those with ALgI were more likely female (61% vs. 35.7%, p = 0.006) with higher body mass index (BMI; 32.9 vs. 28.1, p = 0.03) and lower height (166 vs. 171.1 cm, p = 0.01). Decannulation rates in patients with ALgI were 69.4% compared to 84.3% in patients without ALgI (p = 0.053). Patients with ALgI were scoped more quickly post-extubation (28.8 vs. 36.6 days, p = 0.04), but time to decannulation did not differ (66.6 vs. 81.2 days, p = 0.74). Lower CCI (4.03 vs 6.93) and lack of tobacco use (41.2% vs 73.3%) were associated with successful decannulation (p = 0.038, p = 0.0008). Patients with ALgI treated conservatively (observation or medical management) were decannulated up to 71 days post-extubation. Further decannulations only occurred with surgical intervention.
CONCLUSIONS: Female gender, higher BMI, and shorter height are associated with ALgI among patients undergoing a LTACH screening evaluation. CCI and tobacco have a negative association with decannulation success. Among the ALgI cohort, no patient treated conservatively was decannulated after 71 days.
METHODS: 4 Laryngoscope, 2024.
方法:回顾性研究在2019年至2022年在一家长期急性护理医院(LTACH)进行气管造口术的插管后患者进行筛查评估。
结果:患者在拔管后平均随访115天。119名成年患者中有49名患有ALgI。患有ALgI的人更有可能是女性(61%vs.35.7%,p=0.006),体重指数较高(BMI;32.9vs.28.1,p=0.03)和较低的高度(166与171.1cm,p=0.01)。ALgI患者的拔管率为69.4%,而无ALgI患者的拔管率为84.3%(p=0.053)。ALgI患者在拔管后更快地进行范围检查(28.8vs.36.6天,p=0.04),但拔管时间没有差异(66.6与81.2天,p=0.74)。较低的CCI(4.03vs6.93)和缺乏烟草使用(41.2%vs73.3%)与成功拔管相关(p=0.038,p=0.0008)。保守治疗(观察或医学管理)的ALgI患者拔管后长达71天。仅在手术干预下才会发生进一步的脱环。
结论:女性性别,BMI较高,在接受LTACH筛查评估的患者中,较短的身高与ALgI相关。CCI和烟草与拔管成功呈负相关。在ALgI队列中,保守治疗的患者在71天后均未脱管.
方法:4喉镜,2024.