{Reference Type}: Journal Article
{Title}: Predictors and prognosis of tracheostomy in relapsing polychondritis.
{Author}: Yin R;Xu D;Wang Q;Li M;Zhang W;Zhang F;Zeng X;Jiang N;Hou Y;
{Journal}: Rheumatology (Oxford)
{Volume}: 0
{Issue}: 0
{Year}: 2023 Nov 2
{Factor}: 7.046
{DOI}: 10.1093/rheumatology/kead588
{Abstract}: <B>OBJECTIVE: </B>Airway obstruction can occur in patients with relapsing polychondritis (RP) with laryngeal involvement, occasionally requiring tracheostomy to avoid serious complications. Herein, we assessed the risk factors for tracheostomy and developed a risk prediction model.<BR><B>METHODS: </B>Clinical characteristics of patients with RP, with and without tracheostomy, were compared using multivariate logistic regression analysis to identify risk factors. A nomogram was developed to predict the population at risk of requiring tracheostomy.<BR><B>RESULTS: </B>In total, 232 patients with RP were reviewed, of whom 146 had laryngeal involvement. Among them, 21 underwent a tracheostomy. Multivariate logistic analysis identified ages ≤ 25 or ≥ 65 (p< 0.001, OR: 24.584, 95% CI: 5.310-113.815), laryngotracheal oedema (p< 0.001, OR: 26.685, 95% CI: 4.208-169.228), and pulmonary infection (p= 0.001, OR: 18.834, 95% CI: 3.172-111.936) as independent risk factors for tracheostomy. A nomogram with a C-index of 0.936 (95% CI: 0.894-0.977) was established based on the multivariate analysis. Internal bootstrap resampling (1000 repetitions) confirmed sufficient discriminatory power with a C-index of 0.926. Decision curve analysis indicated a superior net benefit of the nomogram. Tracheostomy was associated with a significant increase in the in-hospital mortality rate (p= 0.021), but it did not affect the long-term survival rate (p= 0.706).<BR><B>CONCLUSIONS: </B>Tracheostomy is associated with an increase in the short-term mortality rate but does not affect the long-term survival rate. The nomogram developed in this study may help identify patients at high risk for tracheostomy and aid in clinical decision-making.