Zarrizi Maryam, Paryad Ezzat, Ghanbari Khanghah Atefeh, Kazemnezhad Leili Ehsan, Faghani Hamed
Critical Care Nursing, Dr. Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran.
GI Cancer Screening and Prevention Research Center (GCSPRC), Department of Nursing (Medical-Surgical), Instructor, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
Tanaffos. 2020 Jul;19(3):235-242.
In elderly patients, the management of the endotracheal tube after coronary artery bypass graft (CABG) can be challenging because they often have complex comorbidities. This study was done to determine endotracheal tube duration in elderly patients after CABG.
This retrospective study was conducted on 397 patients aged over 65 years under mechanical ventilation after CABG. Patients in two groups of endotracheal tube duration of less than 8 h and more than 8 h were compared. Medical records were used for data gathering. Descriptive statistics, Mann-Whitney U, Kruskal-Wallis test, and logistic regression model were used for data analysis.
Endotracheal tube duration was 9.9± 5.89 h in elderly patients. According to the results of the Mann-Whitney U test, there was a significant difference between the two groups in terms of the history of smoking (p = 0.023), history of diabetes (p= 0.062), left ventricular ejection fraction (p= 0.028), and type of operation in terms of emergency and non-emergency (p= 0.069). The logistic regression model showed predictive variables of the endotracheal tube duration after CABG in elderly patients over 65 years, including the history of smoking (1.179- 4.543, CI: 95%, β=0.839, and, p=0.015), history of myocardial infarction (0.188- 1.019, CI: 95%, p= 0.055, β= -0.827), and the left ventricular ejection fraction less than 50% (0.202-0752, CI: 95%, p= 0.005, β= -0.943).
Considering the predictive factors, the duration of the postoperative endotracheal tube can play an important role in the careful care of elderly patients after CABG.
在老年患者中，冠状动脉旁路移植术（CABG）后气管插管的管理具有挑战性，因为他们往往有复杂的合并症。本研究旨在确定老年CABG患者的气管插管时长。
本回顾性研究针对397例65岁以上CABG术后接受机械通气的患者。比较气管插管时长小于8小时和大于8小时的两组患者。通过病历收集数据。采用描述性统计、曼-惠特尼U检验、克鲁斯卡尔-沃利斯检验和逻辑回归模型进行数据分析。
老年患者的气管插管时长为9.9±5.89小时。根据曼-惠特尼U检验结果，两组在吸烟史（p = 0.023）、糖尿病史（p = 0.062）、左心室射血分数（p = 0.028）以及急诊和非急诊手术类型（p = 0.069）方面存在显著差异。逻辑回归模型显示，65岁以上老年CABG患者气管插管时长的预测变量包括吸烟史（1.179 - 4.543，CI：95%，β = 0.839，p = 0.015）、心肌梗死史（0.188 - 1.019，CI：95%，p = 0.055，β = -0.827）以及左心室射血分数小于50%（0.202 - 0.752，CI：95%，p = 0.005，β = -0.943）。
考虑到这些预测因素，术后气管插管时长在老年CABG患者的精心护理中可发挥重要作用。
