Nicolli E A, Carey R M, Farquhar D, Haft S, Alfonso K P, Mirza N
Department of Otorhinolaryngology: Head and Neck Surgery,University of Pennsylvania,Philadelphia,USA.
J Laryngol Otol. 2017 Mar;131(3):264-267. doi: 10.1017/S0022215116009798. Epub 2016 Dec 23.
The aetiology and outcomes for patients with acquired subglottic stenosis are highly variable. This study aimed to identify risk factors for subglottic stenosis and patient characteristics that predict long-term clinical outcomes.
A retrospective review was performed on 63 patients with subglottic stenosis and 63 age-matched controls. Patient demographics and clinical characteristics were compared. Subglottic stenosis patients were further grouped according to tracheostomy status (i.e. tracheostomy never required, tracheostomy initially required but patient eventually decannulated, and tracheostomy-dependent). Patient factors from these three groups were then compared to evaluate risk factors for long-term tracheostomy dependence.
Compared to controls, patients with subglottic stenosis had a significantly higher body mass index (30.8 vs 26.0 kg/m2; p < 0.001) and were more likely to have diabetes (23.8 per cent vs 7.94 per cent; p = 0.01). Comparing tracheostomy outcomes within the subglottic stenosis group, body mass index trended towards significance (p = 0.08). Age, gender, socio-economic status, subglottic stenosis aetiology and other co-morbidities did not correlate with outcome.
Obesity and diabetes are significant risk factors for acquiring subglottic stenosis. Further investigations are required to determine if obesity is also a predictor for failed tracheostomy decannulation in subglottic stenosis.
获得性声门下狭窄患者的病因和预后差异很大。本研究旨在确定声门下狭窄的危险因素以及预测长期临床预后的患者特征。
对63例声门下狭窄患者和63例年龄匹配的对照者进行回顾性研究。比较患者的人口统计学和临床特征。声门下狭窄患者根据气管切开状态进一步分组（即从未需要气管切开、最初需要气管切开但患者最终拔管、依赖气管切开）。然后比较这三组患者的因素，以评估长期依赖气管切开的危险因素。
与对照组相比，声门下狭窄患者的体重指数显著更高（30.8 vs 26.0 kg/m2；p < 0.001），且更易患糖尿病（23.8% vs 7.94%；p = 0.01）。在声门下狭窄组内比较气管切开结果时，体重指数有显著趋势（p = 0.08）。年龄、性别、社会经济状况、声门下狭窄病因和其他合并症与预后无关。
肥胖和糖尿病是获得性声门下狭窄的重要危险因素。需要进一步研究以确定肥胖是否也是声门下狭窄患者气管切开拔管失败的预测因素。
