Predictors of Posterior Glottic Stenosis: A Multi-Institutional Case-Control Study.
Predictors of Posterior Glottic Stenosis: A Multi-Institutional Case-Control Study.
复制标题
DOI：
10.1177/0003489415608867
复制
发表时间：
2016-03
期刊：
影响因子：
--
通讯作者：
North American Airway Collaborative (NoAAC)
中科院分区：
文献类型：
--
作者：
Hillel AT;Karatayli-Ozgursoy S;Samad I;Best SR;Pandian V;Giraldez L;Gross J;Wootten C;Gelbard A;Akst LM;Johns MM;North American Airway Collaborative (NoAAC)
评估插管患者发生声门后狭窄（PGS）的内在和外在危险因素。 2012 年 9 月至 2014 年 5 月期间在三所三级护理大学医院诊断的 PGS 患者被纳入其中。记录患者人口统计数据、合并症、插管持续时间、ETT 大小和插管指征。将 PGS 患者与以重症监护病房 (ICU) 插管患者为代表的对照患者进行比较。确定了 36 名 PGS 患者。排除后，对 28 名 PGS 患者（14 名男性，14 名女性）和 112 名对照者（65 名男性，47 名女性）进行了研究。多变量分析表明，缺血（p<0.05）、糖尿病（p<0.01）、插管时间（p<0.01）是发生 PGS 的重要危险因素。 14/14 (100%) 的男性接受了 8 号或更大的 ETT 插管，而男性对照组的比例为 47/65 (72.3%) (p<0.05)。 PGS (p<0.01)、插管长度 (p<0.001) 和阻塞性睡眠呼吸暂停 (p<0.05) 是气管切开术的显着危险因素。插管持续时间、缺血、糖尿病和男性 ETT 尺寸较大（8 或更大）是发生 PGS 的重要危险因素。在高危患者中减少 8 号 ETT 的使用和早期计划的气管切开术可能会降低 PGS 的发生率并提高 ICU 的安全性。
To assess intrinsic and extrinsic risk factors in the development of posterior glottic stenosis (PGS) in intubated patients. PGS patients diagnosed between September 2012 – May 2014 at three tertiary care university hospitals were included. Patient demographics, comorbidities, duration of intubation, ETT size, and indication for intubation were recorded. PGS patients were compared to control patients represented by patients intubated in intensive care units (ICU). Thirty-six PGS patients were identified. After exclusion, 28 PGS patients (14 male, 14 female) and 112 (65 male, 47 female) controls were studied. Multivariate analysis demonstrated ischemia (p<0.05), diabetes (p<0.01), length of intubation (p<0.01) were significant risk factors for the development of PGS. 14/14 (100%) males were intubated with a size 8 or larger ETT compared to 47/65 (72.3%) male controls (p<0.05). PGS (p<0.01), length of intubation (p<0.001), and obstructive sleep apnea (p<0.05) were significant risk factors for tracheostomy. Duration of intubation, ischemia, diabetes mellitus, and large ETT size (8 or greater) in males were significant risk factors for the development of PGS. Reducing the use of size 8 ETTs and earlier planned tracheostomy in high-risk patients may reduce the incidence of PGS and improve ICU safety.