Giresun University, Faculty of Medicine, Department of Anesthesiology and Reanimation - Giresun, Turkey.
Giresun Prof. Dr. A. Ilhan Ozdemir State Hospital, Department of Anesthesiology and Reanimation - Giresun, Turkey.
Rev Assoc Med Bras (1992). 2023 Sep 25;69(10):e20230832. doi: 10.1590/1806-9282.20230832. eCollection 2023.
The objective of this study was to compare the clinical outcomes of percutaneous dilatational tracheostomy in COVID-19 and non-COVID-19 patients.
A total of 48 patients who underwent percutaneous dilatational tracheostomy, with 24 COVID-19 patients (Group C) and 24 non-COVID-19 patients (Group N), were included in the study. Patients' demographic features including age and gender, time to intubation, duration of intubation, Acute Physiology and Chronic Health Evaluation scores, comorbidities, duration of opening tracheostomy, complications, duration of mechanical ventilation, length of stay in the intensive care units, and mortality were recorded and compared between the groups.
There was no statistically significant difference between the groups regarding age and gender (p=0.558 and p=0.110, respectively). Time to intubation was significantly more prolonged, and intubation follow-up duration was significantly shorter in Group C compared to Group N (p=0.034 and p=0.002, respectively). The Acute Physiology and Chronic Health Evaluation score was statistically significantly higher in Group N compared with Group C (p=0.012). The most common comorbidity was hypertension in 29 (60.4%) patients, followed by cerebrovascular disease in 19 (39.6%) patients. There was no statistically significant difference between the groups regarding mortality (p=0.212).
This study suggests that percutaneous dilatational tracheostomy can be performed safely in COVID-19 and non-COVID-19 patients. However, COVID-19 patients may have a longer time to intubation and shorter intubation follow-up duration than non-COVID-19 patients. The study also found a higher incidence of complications in COVID-19 patients undergoing percutaneous dilatational tracheostomy. These results emphasize the importance of careful patient selection, meticulous technique, and close postoperative monitoring in patients undergoing percutaneous dilatational tracheostomy, particularly in those with COVID-19.
本研究旨在比较 COVID-19 与非 COVID-19 患者行经皮扩张气管切开术的临床结局。
共纳入 48 例行经皮扩张气管切开术的患者，其中 COVID-19 患者 24 例（C 组），非 COVID-19 患者 24 例（N 组）。记录并比较两组患者的人口统计学特征（年龄、性别）、置管时间、置管时间、急性生理学和慢性健康评估评分、合并症、气管切开开放时间、并发症、机械通气时间、重症监护病房住院时间和死亡率。
两组患者在年龄和性别方面无统计学差异（p=0.558 和 p=0.110）。C 组患者置管时间明显延长，置管后随访时间明显缩短（p=0.034 和 p=0.002）。N 组患者急性生理学和慢性健康评估评分明显高于 C 组（p=0.012）。最常见的合并症是高血压，共 29 例（60.4%），其次是脑血管疾病，共 19 例（39.6%）。两组患者死亡率无统计学差异（p=0.212）。
本研究表明，经皮扩张气管切开术可安全应用于 COVID-19 与非 COVID-19 患者。然而，COVID-19 患者的置管时间可能更长，置管后随访时间更短。本研究还发现，COVID-19 患者行经皮扩张气管切开术的并发症发生率更高。这些结果强调了在为行经皮扩张气管切开术的患者进行仔细的患者选择、细致的技术操作和密切的术后监测的重要性，特别是在 COVID-19 患者中。
