Asik Mehmet Burak, Birkent Hakan
Department of Otolaryngology, Head and Neck Surgery, Gulhane Research and Training Hospital, Ankara, Turkey.
Department of Otolaryngology, Head and Neck Surgery, Centrium Hospital, Istanbul, Turkey.
Indian J Otolaryngol Head Neck Surg. 2019 Oct;71(Suppl 1):510-514. doi: 10.1007/s12070-018-1375-7. Epub 2018 May 2.
Laryngotracheal stenosis (LTS) is a life threatening airway problem that is mainly caused by prolonged intubation. The authors intend to assess whether there was variability in the risk factors depending on age, and to determine which risk factors and comorbidities were more important in the development of LTS at older or younger ages. Fifty-two LTS patients were evaluated for comorbidities and risk factors retrospectively. The LTS etiologies, demographics, and medical and surgical histories of the patients were determined by the medical records. The patients under 40 years old were defined as group 1, and the patients 40 years of age or older were defined as group 2. Our study revealed that with regard to GERD, hypertension, DM2, and pulmonary infection, there was a statistically significant difference between group 1 and group 2 ( = 0.025, = 0.0005, = 0.002, and = 0.000, respectively). Those patients ≥ 40 years old exhibited higher rates of GERD, hypertension, DM2, and pulmonary infection. However, there were no statistically significant differences between the groups with regard to smoking, alcohol consumption, COPD/asthma, immunological disease, and obesity (BMI > 30). There was a statistically significant difference between the groups for all the risk factors except a previous tracheotomy ( = 0.115). The risk factors and comorbidities thought to be involved in the development of LTS could show age-related variability. Therefore, in patients over 40 years of age with comorbidities (GERD, hypertension, DM2, and pulmonary infection), it is necessary to take precautions before the development of LTS. Prolonged intubation and tracheotomy history are the main risk factors for all patients, regardless of age.
喉气管狭窄(LTS)是一种危及生命的气道问题,主要由长时间插管引起。作者旨在评估风险因素是否因年龄而异,并确定哪些风险因素和合并症在老年或年轻患者发生LTS时更为重要。对52例LTS患者的合并症和风险因素进行了回顾性评估。通过病历确定患者的LTS病因、人口统计学特征以及内科和外科病史。40岁以下的患者被定义为第1组,40岁及以上的患者被定义为第2组。我们的研究表明,在胃食管反流病(GERD)、高血压、2型糖尿病(DM2)和肺部感染方面,第1组和第2组之间存在统计学显著差异(分别为=0.025、=0.0005、=0.002和=0.000)。那些年龄≥40岁的患者GERD、高血压、DM2和肺部感染的发生率更高。然而,在吸烟、饮酒、慢性阻塞性肺疾病/哮喘、免疫性疾病和肥胖(体重指数>30)方面,两组之间没有统计学显著差异。除既往气管切开术外,所有风险因素在两组之间均存在统计学显著差异(=0.115)。被认为与LTS发生有关的风险因素和合并症可能表现出与年龄相关的变异性。因此,对于40岁以上患有合并症(GERD、高血压、DM2和肺部感染)的患者,在LTS发生之前有必要采取预防措施。无论年龄大小,长时间插管和气管切开史都是所有患者的主要风险因素。