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Clinicodemographic Predictors of Tracheotomy Tube Size and Decannulation: A Multiinstitutional Retrospective Cohort Study on Tracheotomy.
Panuganti, Bharat Akhanda; Pang, John; Francis, David O; Klebaner, Dasha; Asturias, Alicia; Alattar, Ali; Wood, Samuel; Terry, Morgan; Bryson, Paul C; Tipton, Courtney B; Zhao, Elise E; O'Rourke, Ashli; Maria, Chloe Santa; Grimm, David R; Sung, C Kwang; Lao, Wilson P; Thompson, Jordan M; Crawley, Brianna K; Rosen, Sarah; Berezovsky, Anna; Kupfer, Robbi; Hennesy, Theresa B; Clary, Matthew; Joseph, Ian T; Sarhadi, Kamron; Kuhn, Maggie; Abdel-Aty, Yassmeen; Kennedy, Maeve M; Lott, David G; Weissbrod, Philip A.
Afiliação
  • Panuganti BA; University of California San Diego, Department of Otolaryngology, La Jolla, CA.
  • Pang J; University of Washington, Department of Otolaryngology, Seattle, WA.
  • Francis DO; University of Wisconsin, Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Madison, WI.
  • Klebaner D; University of California, School of Medicine, La Jolla, CA.
  • Asturias A; University of California, School of Medicine, La Jolla, CA.
  • Alattar A; University of California, School of Medicine, La Jolla, CA.
  • Wood S; University of California, School of Medicine, La Jolla, CA.
  • Terry M; Cleveland Clinic, Department of Otolaryngology, Cleveland, OH.
  • Bryson PC; Cleveland Clinic, Department of Otolaryngology, Cleveland, OH.
  • Tipton CB; Medical University of South Carolina, Department of Otolaryngology, Charleston, SC.
  • Zhao EE; Medical University of South Carolina, Department of Otolaryngology, Charleston, SC.
  • O'Rourke A; Medical University of South Carolina, Department of Otolaryngology, Charleston, SC.
  • Maria CS; Stanford University, Department of Otolaryngology, Palo Alto, CA.
  • Grimm DR; Stanford University, Department of Otolaryngology, Palo Alto, CA.
  • Sung CK; Stanford University, Department of Otolaryngology, Palo Alto, CA.
  • Lao WP; Loma Linda University, Department of Otolaryngology, Loma Linda, CA.
  • Thompson JM; Loma Linda University, Department of Otolaryngology, Loma Linda, CA.
  • Crawley BK; Loma Linda University, Department of Otolaryngology, Loma Linda, CA.
  • Rosen S; University of Wisconsin, Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Madison, WI.
  • Berezovsky A; University of Michigan, Department of Otolaryngology, Ann Arbor, MI.
  • Kupfer R; University of Michigan, Department of Otolaryngology, Ann Arbor, MI.
  • Hennesy TB; University of Colorado, Department of Otolaryngology, Aurora, CA.
  • Clary M; University of Colorado, Department of Otolaryngology, Aurora, CA.
  • Joseph IT; University of California Davis, Department of Otolaryngology, Sacramento, CA; and.
  • Sarhadi K; University of California Davis, Department of Otolaryngology, Sacramento, CA; and.
  • Kuhn M; University of California Davis, Department of Otolaryngology, Sacramento, CA; and.
  • Abdel-Aty Y; Medical University of South Carolina, Department of Otolaryngology, Charleston, SC.
  • Kennedy MM; Mayo Clinic Arizona, Department of Otolaryngology, Phoenix, AZ.
  • Lott DG; Mayo Clinic Arizona, Department of Otolaryngology, Phoenix, AZ.
  • Weissbrod PA; University of California San Diego, Department of Otolaryngology, La Jolla, CA.
Ann Surg ; 277(5): e1138-e1142, 2023 05 01.
Article em En | MEDLINE | ID: mdl-35001037
OBJECTIVE: We aimed to discern clinico-demographic predictors of large (≥8) tracheostomy tube size placement, and, secondarily, to assess the effect of large tracheostomy tube size and other parameters on odds of decannulation before hospital discharge. SUMMARY OF BACKGROUND DATA: Factors determining choice of tracheostomy tube size are not well-characterized in the current literature, despite evidence linking large tracheostomy tube size with posttracheotomy tracheal stenosis. The effect of tracheostomy tube size on timing of decannulation is also unknown, an important consideration given reported associations between endotracheal tube size and probability of failed extubation. METHODS: We collected information pertaining to patients who underwent tracheotomy at 1 of 10 U.S. health care institutions between 2010 and 2019. Tracheostomy tube size was dichotomized (≥8 and <8). Multivariable logistic regression models were fit to identify predictors of (1) large tracheostomy tube size, and (2) decannulation before hospital discharge. RESULTS: The study included 5307 patients, including 2797 (52.7%) in the large tracheostomy cohort. Patient height (odds ratio [OR] = 1.060 per inch; 95% confidence interval [CI] 1.041-1.070) and obesity (1.37; 95% CI 1.1891.579) were associated with greater odds of large tracheostomy tube; otolaryngology performing the tracheotomy was associated with significantly lower odds of large tracheostomy tube (OR = 0.155; 95% CI 0.131-0.184). Large tracheostomy tube size (OR = 1.036; 95% CI 0.885-1.213) did not affect odds of decannulation. CONCLUSIONS: Obesity was linked with increased likelihood of large tracheostomy tube size, independent of patient height. Probability of decannulation before hospital discharge is influenced by multiple patient-centric factors, but not by size of tracheostomy tube.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Traqueotomia / Traqueostomia Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Ann Surg Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Traqueotomia / Traqueostomia Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Ann Surg Ano de publicação: 2023 Tipo de documento: Article