Zengin Hilal, Can Karahan Zehra
Department of Palliative Care Unit, Anesthesioloji and Reanimation Clinic, Gulhane Training and Research Hospital, Healthy Scientists University, Ankara,Turkey.
Department of Physical Therapy and Rehabilitation, Atılım University, Ankara,Turkey.
Ear Nose Throat J. 2024 Oct 27:1455613241293672. doi: 10.1177/01455613241293672.
World Health Organization defines palliative care as a multidisciplinary approach to enhancing patients physical, psychological, and emotional well-being. Our study investigated palliative care unit decannulation rates and factors affecting success. The data of patients hospitalized in the palliative care clinic between 2017 and 2019 were analyzed retrospectively. Demographic data, diagnoses, comorbidities, nutritional status, Norton and Braden Scale scores, day of hospitalization, and discharge direction of the patients were recorded. All patients were evaluated and treated by a multidisciplinary team. One hundred two tracheostomy patients were monitored. Patients in the palliative care clinic had an average stay of 22.19 ± 13.67 days (median: 21, min: 4, max: 66). Forty-one patients were decannulated. Statistically significant age difference was observed between decannulated and non-cannulated groups, with the decannulated group having a significantly lower mean age (52.10 ± 20.54, median: 53) compared to the non-decannulated group (61.48 ± 18.07) ( = -2.516, = .012). The mean Braden scale score of the decannulated group (14.29 ± 2.50) was significantly higher than that of the non-decannulated group (12.20 ± 2.82) ( = 3.823, < .001), and the mean Norton scale score of the decannulated group (11.34 ± 2.50) was significantly higher than that of the non-decannulated group (9.46 ± 2.46) ( = 3.472, = .001). Patients with tracheostomy can be easily followed and decannulated in palliative care clinics. It is important that a multidisciplinary team is involved in palliative care units. Age, immobility, Norton and Braden scales, and level of consciousness are factors affecting the success of decannulation.
世界卫生组织将姑息治疗定义为一种多学科方法,旨在提高患者的身体、心理和情感幸福感。我们的研究调查了姑息治疗病房的拔管率及影响成功拔管的因素。对2017年至2019年期间在姑息治疗诊所住院的患者数据进行了回顾性分析。记录了患者的人口统计学数据、诊断、合并症、营养状况、诺顿和布拉德恩量表评分、住院天数以及出院方向。所有患者均由多学科团队进行评估和治疗。对102例气管切开患者进行了监测。姑息治疗诊所的患者平均住院时间为22.19±13.67天(中位数:21天,最小值:4天,最大值:66天)。41例患者成功拔管。在成功拔管组和未拔管组之间观察到了具有统计学意义的年龄差异,成功拔管组的平均年龄(52.10±20.54,中位数:53岁)显著低于未拔管组(61.48±18.07)(t=-2.516,p=.012)。成功拔管组的平均布拉德恩量表评分(14.29±2.50)显著高于未拔管组(12.20±2.82)(t=3.823,p<.001),成功拔管组的平均诺顿量表评分(11.34±2.50)显著高于未拔管组(9.46±2.46)(t=3.472,p=.001)。气管切开患者在姑息治疗诊所能够很容易地得到随访并成功拔管。多学科团队参与姑息治疗病房的工作很重要。年龄、活动能力、诺顿和布拉德恩量表以及意识水平是影响拔管成功的因素。