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接受永久性与临时性气管切开术的创伤患者的临床特征及死亡相关因素

Clinical Characteristics and Mortality-Associated Factors in Trauma Patients Undergoing Permanent Versus Temporary Tracheostomy.

作者信息

Alnemare Ahmad K

机构信息

Department of Otolaryngology, Faculty of Medicine, Majmaah University, Al-Majmaah 11952, Saudi Arabia.

出版信息

Clin Pract. 2025 Jan 4;15(1):12. doi: 10.3390/clinpract15010012.

Abstract

This study evaluated the characteristics, outcomes, and mortality-associated factors in patients who underwent tracheostomy after traumatic injury to optimize clinical decision-making and patient care in critical trauma settings. A retrospective cohort analysis was conducted using the National Trauma Data Bank (NTDB) records from 2013 to 2016. This study included 41,630 adult trauma patients who underwent tracheostomy procedures. Data analysis included descriptive statistics, univariate comparisons, and multivariate logistic regression analyses. The study protocol adhered to STROBE guidelines for observational studies. Analysis of the total cohort revealed that patients with tracheostomy demonstrated high rates of severe injuries (75.2%) and a notable comorbidity burden, including cardiovascular disorders (4.0%) and blood disorders (5.8%). Multivariate analysis revealed that mortality risk was independently associated with advanced age (OR 1.018, 95% CI 1.016-1.021), higher injury severity scores (OR 1.004, CI 1.002-1.007), female sex (OR 1.187, CI 1.078-1.308), and cardiovascular surgical intervention (OR 1.487, CI 1.350-1.638). Among the study population, 7.6% underwent permanent tracheostomy procedures, with these patients showing some distinct clinical characteristics in terms of injury severity and comorbidity profiles. This comprehensive analysis demonstrates the complex clinical characteristics and mortality-associated factors in trauma patients requiring tracheostomy. Key factors influencing survival outcomes include age, injury severity, sex, and cardiovascular surgical intervention. These findings provide valuable insights for clinical decision-making and risk assessment in trauma patients requiring tracheostomy. The observed differences between permanent and temporary tracheostomy patients warrant further investigation with more detailed timing and indication data.

摘要

本研究评估了创伤后接受气管切开术患者的特征、结局及与死亡率相关的因素,以优化重症创伤环境下的临床决策和患者护理。使用2013年至2016年国家创伤数据库(NTDB)记录进行回顾性队列分析。本研究纳入了41630例接受气管切开术的成年创伤患者。数据分析包括描述性统计、单变量比较和多变量逻辑回归分析。研究方案遵循观察性研究的STROBE指南。对整个队列的分析显示,气管切开术患者严重损伤发生率高(75.2%),且存在明显的合并症负担,包括心血管疾病(4.0%)和血液系统疾病(5.8%)。多变量分析显示,死亡风险与高龄(OR 1.018,95%CI 1.016 - 1.021)、更高的损伤严重程度评分(OR 1.004,CI 1.002 - 1.007)、女性(OR 1.187,CI 1.078 - 1.308)以及心血管外科手术干预(OR 1.487,CI 1.350 - 1.638)独立相关。在研究人群中,7.6%接受了永久性气管切开术,这些患者在损伤严重程度和合并症谱方面表现出一些独特的临床特征。这项综合分析表明了需要气管切开术的创伤患者复杂的临床特征和与死亡率相关的因素。影响生存结局的关键因素包括年龄、损伤严重程度、性别和心血管外科手术干预。这些发现为需要气管切开术的创伤患者的临床决策和风险评估提供了有价值的见解。永久性和临时性气管切开术患者之间观察到的差异需要通过更详细的时间和指征数据进行进一步研究。

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