Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.
Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.
Laryngoscope. 2021 Jul;131(7):1463-1467. doi: 10.1002/lary.28967. Epub 2020 Aug 7.
OBJECTIVES/HYPOTHESIS: Little data exists regarding the relationship between socioeconomic and demographic factors and tracheostomy outcomes. The goal of this study was to determine associations between socioeconomic status (SES), demographic factors, and insurance status with hospital length of stay (LOS), intensive care unit (ICU) LOS, and mortality following tracheostomy.
Retrospective cohort study.
A retrospective analysis of all patients who underwent tracheostomy at an urban tertiary-care academic hospital from 2016 to 2017 was performed. Patients were aggregated into low-, middle-, and high-income brackets. Other variables included age, sex, race, ethnicity, body mass index, and Charlson Comorbidity Index (CCI). Outcomes included hospital and ICU LOS, in-hospital mortality, and 30-day mortality following tracheostomy. Outcomes were compared using Kruskal-Wallis tests for continuous variables and χ or Fisher exact tests for categorical variables. The α level was set to .05.
In total, 523 patients were included in the study. Patients from high-income areas were more likely to be male (P < .01), white (P < .01), and had lower body mass index (P = .04). On multiple regression analysis, Hispanic or Latino ethnicity was associated with an increased odds of 30-day mortality (odds ratio [OR]: 4.43, P = .020). CCI was also associated with increased odds of 30-day mortality (OR: 1.12, P = .039).
Lower SES was not associated with increased morbidity or mortality after tracheostomy. Although Hispanic patients tended to have a lower CCI score, they had increased 30-day mortality, suggesting there are factors specific to this population that may influence outcomes, and future targeted studies are warranted to study these relationships.
4 Laryngoscope, 131:1463-1467, 2021.
目的/假设：关于社会经济和人口统计学因素与气管造口术结果之间的关系，数据很少。本研究的目的是确定社会经济地位（SES）、人口统计学因素和保险状况与气管造口术后住院时间（LOS）、重症监护病房（ICU）LOS 和死亡率之间的关联。
回顾性队列研究。
对 2016 年至 2017 年在城市三级保健学术医院接受气管造口术的所有患者进行回顾性分析。将患者分为低收入、中收入和高收入群体。其他变量包括年龄、性别、种族、族裔、体重指数和 Charlson 合并症指数（CCI）。结果包括医院和 ICU LOS、院内死亡率以及气管造口术后 30 天死亡率。使用 Kruskal-Wallis 检验比较连续变量，使用 χ 或 Fisher 确切检验比较分类变量。α 水平设为.05。
共有 523 名患者纳入研究。高收入地区的患者更可能是男性（P < .01）、白人（P < .01），体重指数较低（P = .04）。多元回归分析显示，西班牙裔或拉丁裔种族与 30 天死亡率增加的几率相关（比值比[OR]：4.43，P = .020）。CCI 也与 30 天死亡率增加的几率相关（OR：1.12，P = .039）。
较低的 SES 与气管造口术后的发病率或死亡率增加无关。尽管西班牙裔患者的 CCI 评分往往较低，但他们的 30 天死亡率较高，这表明该人群存在影响结果的特定因素，需要进一步的有针对性的研究来研究这些关系。
4 级喉镜，131：1463-1467，2021。
