Gupta Nitika, Saraf Aditiya, Bashir Aadil, Shivgotra Dikshit, Kalsotra Parmod
Department of ENT and Head and Neck Surgery, SMGS Hospital, Government Medical College Jammu, Jammu, J&K, India.
Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3679-3685. doi: 10.1007/s12070-023-04025-4. Epub 2023 Jul 16.
Comparative evaluation of early and late tracheostomy outcomes in mechanically ventilated patients. The present retrospective study was conducted in Government medical college Jammu from April 2021 to November 2022 on 111 tracheotomised patient in intensive care unit. All tracheostomies with in 10 days of intubation were grouped as early tracheostomy (ET) group and all those done after 10 days were grouped as LATE TRACHEOSTOMY (LT) group. APACHE II score at the time of intensive care unit admission of all included tracheotomised patients was noted. Data regarding mortality, duration of mechanical ventilation and length of stay in intensive care unit (ICU) was studied. Mean age of presentation was 41.5 ± 15.7 yrs, with male preponderance. Out of 111 patients, 57 patients underwent early tracheostomy and 54 underwent late TRACHEOSTOMY. In APACHE II, < 25 category-short term mortality was 4 in ET and 5 in LT; long term mortality in ET was 4 and 10 in LT; average days of mechanical ventilation were 11.2 in ET and 3 in LT; average stay in ICU was 18 days in ET and 61 days in LT. in APACHE II > 25-short term mortality was 4 in ET and 5 in LT; long term mortality in ET was 3 and 9 in LT. Average days of mechanical ventilation were 10.8 in ET and 57 in LT; average stay in ICU was 24 days in ET and 79 days in LT. Early tracheostomy is superior to late Tracheostomy in terms of mortality, number of days of mechanical ventilation and the duration of intensive care unit stay.
机械通气患者早期与晚期气管切开术结局的比较评估。本回顾性研究于2021年4月至2022年11月在查谟政府医学院对111例重症监护病房中行气管切开术的患者进行。所有在插管后10天内进行的气管切开术患者被归为早期气管切开术（ET）组，所有在10天后进行的患者被归为晚期气管切开术（LT）组。记录了所有纳入的气管切开术患者入住重症监护病房时的急性生理与慢性健康状况评分系统（APACHE II）评分。研究了关于死亡率、机械通气持续时间以及在重症监护病房（ICU）住院时间的数据。患者的平均就诊年龄为41.5±15.7岁，男性占多数。111例患者中，57例行早期气管切开术，54例行晚期气管切开术。在APACHE II评分＜25分的患者中，ET组短期死亡率为4例，LT组为5例；ET组长期死亡率为4例，LT组为10例；ET组机械通气平均天数为11.2天，LT组为3天；ET组在ICU的平均住院时间为18天，LT组为61天。在APACHE II评分＞25分的患者中，ET组短期死亡率为4例，LT组为5例；ET组长期死亡率为3例，LT组为9例。ET组机械通气平均天数为10.8天，LT组为57天；ET组在ICU的平均住院时间为24天，LT组为79天。在死亡率、机械通气天数和重症监护病房住院时间方面，早期气管切开术优于晚期气管切开术。
