Predictors and prognosis of tracheostomy in relapsing polychondritis.
Rheumatology (Oxford)
; 2023 Nov 02.
Article
in En
| MEDLINE
| ID: mdl-37934151
ABSTRACT
OBJECTIVE:
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.METHODS:
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.RESULTS:
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).CONCLUSION:
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.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
Rheumatology (Oxford)
Journal subject:
REUMATOLOGIA
Year:
2023
Document type:
Article