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居家医疗保健对气管切开术患者管理的效果。

Efficacy of home healthcare on the management of tracheostomy patients.

机构信息

From the College of Medicine (Almansour, AlHedyan, Alshathri, Alsubaie, Alsuliman, Alseraya), King Saud bin Abdulaziz for Health Sciences; from the King Abdulaziz Medical City (Almansour, AlHedyan, Alshathri, Alsubaie, Alsuliman, Alseraya), Ministry of National Guard Health Affairs; from the Department of Medical Education (Omair), College of Medicine, King Saud bin Abdulaziz for Health Sciences; and from the Division of Adult Home Health Care Department (Alanazi, Alseraya), King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia.

出版信息

Saudi Med J. 2024 Jul;45(7):724-730. doi: 10.15537/smj.2024.45.7.20240294.

Abstract

OBJECTIVES

To evaluated the home healthcare efficacy in managing tracheostomy patients at King Abdulaziz Medical City under the Ministry of National Guard Health Affairs. Home healthcare is care provided to patients in the convenience of their homes to ensure high-quality care based on healthcare providers' supervision.

METHODS

This retrospective cohort study utilizing a non-probability consecutive sampling technique, including all available tracheal patients with no exclusion criteria, was carried out in Riyadh, Saudi Arabia, between January 2019 and June 2022. The collected data included patient demographic variables and respiratory settings (ventilation type, daily ventilation need, tracheostomy duration, and ventilator settings). The outcomes included mortality rate and therapeutic outcomes of tracheal management.

RESULTS

Of the 183 patients in the study, the most common type of respiratory-related infection was pneumonia (53%). Unlike respiratory-related causes, The mortality rate of patients admitted to the intensive care unit that was unrelated to respiratory causes was statistically significant (57%) (=0.003). The mortality rate of patients who used aerosol tracheal collars (34%) was markedly higher than mechanically ventilated patients (57%) (=0.004). The mortality rate following discharge from HHC was 40%, and was higher among patients aged >70 years (47%) (=0.04).

CONCLUSION

Pneumonia was associated with the majority of ventilator-related infections and resulted in hospital readmissions. Ensuring proper practices and caregiver education is crucial to decrease the incidence of ventilator-related infections.

摘要

目的

评估沙特阿拉伯卫生部国民警卫队健康事务部阿卜杜勒-阿齐兹国王医疗城(King Abdulaziz Medical City)对气管切开患者进行家庭医疗护理的效果。家庭医疗护理是指在患者家中为其提供护理服务,以确保在医疗服务提供者的监督下提供高质量的护理。

方法

本回顾性队列研究采用非概率连续抽样技术,纳入了 2019 年 1 月至 2022 年 6 月期间在沙特阿拉伯利雅得的所有无排除标准的可进行气管切开的患者。收集的数据包括患者的人口统计学变量和呼吸设置(通气类型、每日通气需求、气管切开持续时间和呼吸机设置)。结果包括死亡率和气管管理的治疗效果。

结果

在 183 例患者中,最常见的与呼吸相关的感染是肺炎(53%)。与呼吸相关原因不同,因与呼吸无关的原因而入住重症监护病房的患者死亡率具有统计学意义(57%)(=0.003)。使用气雾剂气管套的患者(34%)的死亡率明显高于机械通气患者(57%)(=0.004)。家庭医疗护理出院后的死亡率为 40%,年龄>70 岁的患者死亡率更高(47%)(=0.04)。

结论

肺炎与大多数呼吸机相关感染有关,并导致患者再次住院。确保正确的操作和护理人员教育对于降低呼吸机相关感染的发生率至关重要。

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