Abstract：
OBJECTIVE: Acute laryngeal injury (ALgI) is an identified complication of prolonged intubation. Its evolution into mature stenosis and factors affecting decannulation are unclear. This retrospective review aims to characterize the incidence and characteristics of ALgI development and decannulation.
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.
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.
摘要：
目的：急性喉损伤（ALgI）是一种长期插管的并发症。其演变为成熟狭窄和影响脱管的因素尚不清楚。本回顾性综述旨在描述ALgI发展和拔管的发生率和特征。
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.
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.
