Tracheotomy outcomes and complications: A national perspective
Tracheotomy outcomes and complications: A national perspective
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DOI：
10.1002/lary.21907
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发表时间：
2012-01-01
期刊：
影响因子：
2.6
通讯作者：
Roberson, David W.
中科院分区：
文献类型：
--
作者：
Shah, Rahul K.;Lander, Lina;Roberson, David W.
目标/假设：提供有关气管切开术频率以及气管切开术后并发症发生率和院内死亡率的国家级数据。研究设计：回顾性队列研究。方法：使用国家公共数据库（2006 年全国住院患者样本）进行回顾性队列研究。结果：2006 年，18 岁或以上的患者中有 113,653 例进行了气管切开术。总体并发症率为 3.2%，院内死亡率为 19.2%。数据表明，院内死亡通常是由于基础疾病而不是气管切开术造成的。 50岁以上患者、患有心脏病（特别是充血性心力衰竭）的患者、拥有公共保险的患者以及东北医院的患者死亡率较高。患有神经系统疾病、创伤和上呼吸道感染的患者更有可能存活并出院。非教学医院的院内死亡率略高。结论：这项数据库研究确定了接受气管切开术的患者并发症发生率 (3.2%) 的基线数据；研究表明，在美国接受气管切开术的成年患者中只有 80% 能够存活并出院。东北地区的患者、50岁以上的患者以及患有心脏病的患者的死亡风险特别高。这项研究为这些结果提供了规范数据，用于患者咨询和规划该患者群体未来的质量改进举措。
Objectives/Hypothesis: To provide national level data on frequency of tracheotomy and complication rate and in-hospital mortality following tracheotomy. Study Design: Retrospective cohort study. Methods: Retrospective cohort study using a public national database, the Nationwide Inpatient Sample, 2006. Results: There were 113,653 tracheotomies performed in patients 18 years or older in 2006. The overall complication rate was 3.2%, and the in-hospital mortality rate was 19.2%. The data suggest that in-hospital mortality is usually due to the underlying illness rather than the tracheotomy. Mortality was higher in patients older than 50 years, those with cardiac conditions, particularly congestive heart failure, those with public insurance, and patients in Northeast hospitals. Patients with neurologic conditions, trauma, and upper airway infection are more likely to survive to discharge. In-hospital mortality is slightly higher in nonteaching hospitals. Conclusions: This database study determined baseline data for the rate of complications (3.2%) for patients undergoing tracheotomy; it showed that only 80% of adult patients who underwent tracheotomy in the United States survived to discharge. Patients located in the Northeast, patients more than 50 years old, and patients with cardiac conditions were at particularly high risk for mortality. This study provides normative data for these outcomes for patient counseling and planning future quality improvement initiatives in this patient population.