Tracheostomy Complications in the Emergency Department: A National Analysis of 38,271 Cases.
ORL J Otorhinolaryngol Relat Spec
; 82(2): 106-114, 2020.
Article
en En
| MEDLINE
| ID: mdl-32036376
ABSTRACT
BACKGROUND:
Greater than 100,000 tracheotomies are performed annually in the USA, yet little is known regarding patients who present to the emergency department (ED) with tracheostomy complications.OBJECTIVES:
To characterize patient and hospital characteristics, outcomes, and charges associated with tracheostomy complications and to identify predictors of admission and mortality.METHODS:
The 2009-2011 Nationwide Emergency Department Sample (NEDS) was queried for patients with a principle diagnosis of tracheostomy complication. A descriptive analysis was performed and multivariable logistic regression was used to identify predictors of admission and mortality.RESULTS:
A total of 69,371 nationwide visits to the ED had tracheostomy complication as an associated ICD-9 diagnosis, of which 55.2% (n = 38,293) carried a primary diagnosis of tracheostomy complication. Unspecified tracheostomy complications were most common (61.4%), followed by mechanical complications (31.3%), and lastly by tracheostomy infections (7.3%). Pediatric patients were significantly more likely to have tracheostomy infections than adults (p < 0.0001). A total of 35.5% of patients with tracheostomy complications were admitted to the hospital, and death occurred with 1.4% of visits. Patients from higher-income ZIP codes had increased odds of admission (adjusted odds ratio [OR] 1.35; p = 0.0009), as did patients with tracheostomy infections (OR 4.425; p < 0.0001). Patients with tracheostomy infections (OR 3.14; p = 0.0062) and unspecified tracheostomy complications (OR 2.00; p = 0.0076) had increased odds of mortality.CONCLUSION:
These findings may help improve overall outcomes amongst patients with tracheostomies by preventing unnecessary ED admissions and improving healthcare provider preparedness and awareness.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
/
Traqueostomía
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Servicio de Urgencia en Hospital
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
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Adult
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Aged
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
ORL J Otorhinolaryngol Relat Spec
Año:
2020
Tipo del documento:
Article