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床边开放式气管切开术的益处:一种安全且具成本效益的手术室替代方案。

Benefits of Bedside Open Tracheostomy: A Safe and Cost-Effective Alternative to the Operating Room.

作者信息

Winchester Arianna, Strum David, Saeedi Arman, Bhatt Nupur, Chow Michael, Mir Ghayoour, Jacobson Adam

机构信息

Department of Otolaryngology-Head and Neck Surgery, New York University Grossman School of Medicine, New York, New York, USA.

Department of Otolaryngology-Head and Neck Robert Wood Johnson Medical Center, Newark, New Jersey, USA.

出版信息

Head Neck. 2025 Feb;47(2):635-639. doi: 10.1002/hed.27948. Epub 2024 Oct 3.

Abstract

INTRODUCTION

Tracheostomy is a commonly performed procedure in Otolaryngology and can be performed in different settings. We evaluate patient characteristics and cost efficacy of tracheostomy at the bedside versus operating room (OR).

MATERIALS AND METHODS

Retrospective chart review was performed for adult intensive care unit (ICU) patients who underwent tracheostomy from 2020 to 2023. Data and cost of procedures were analyzed using descriptive statistics.

RESULTS

One hundred and sixty-five patients were included. One hundred and thirty-four (81.2%) patients underwent bedside tracheostomy. Age, sex, and BMI were not significantly different. Average time from consult to procedure and operative time was significantly shorter (p = 0.03; 0.008). There were no differences in postoperative complications, 30-day mortality, ICU length of stay (LOS), or overall LOS. Tracheostomy at the bedside offered a 73.1% cost reduction compared with performed in the OR.

CONCLUSION

Advantages of bedside tracheostomy include decreased operative time, time from consult to procedure, and cost reduction for the hospital system. We advocate for consideration of bedside tracheostomy when appropriate.

摘要

引言

气管切开术是耳鼻喉科常见的手术,可在不同环境下进行。我们评估了床边气管切开术与手术室气管切开术的患者特征和成本效益。

材料与方法

对2020年至2023年在成人重症监护病房(ICU)接受气管切开术的患者进行回顾性病历审查。使用描述性统计分析手术数据和成本。

结果

纳入165例患者。134例(81.2%)患者接受了床边气管切开术。年龄、性别和体重指数无显著差异。从会诊到手术的平均时间和手术时间显著缩短(p = 0.03;0.008)。术后并发症、30天死亡率、ICU住院时间(LOS)或总住院时间无差异。与在手术室进行气管切开术相比,床边气管切开术使成本降低了73.1%。

结论

床边气管切开术的优点包括缩短手术时间、从会诊到手术的时间以及降低医院系统成本。我们主张在适当情况下考虑床边气管切开术。

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