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新型冠状病毒肺炎(COVID-19)与非新型冠状病毒肺炎气管切开患者的比较:并发症、生存率及死亡风险因素

Comparison of COVID-19 and Non-COVID-19 Tracheostomised Patients: Complications, Survival, and Mortality Risk Factors.

作者信息

Mesalles-Ruiz Marta, Alonso Maitane, Cruellas Marc, Plana Martí, Penella Anna, Portillo Alejandro, Gumucio Víctor Daniel, González-Compta Xavier, Mañós Manel, Nogués Julio

机构信息

Otorhinolaryngology Department, Hospital Universitari de Bellvitge, Carrer de la Feixa Llarga, s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.

Clinical Sciences Department, Universitat de Barcelona, Carrer de Casanova 143, 08036 Barcelona, Spain.

出版信息

J Clin Med. 2025 Jan 19;14(2):633. doi: 10.3390/jcm14020633.

Abstract

To compare the outcomes of tracheostomised COVID-19 patients with non-COVID-19 tracheostomised patients to identify factors influencing severity and mortality. A retrospective, single-centre cohort study was conducted on COVID-19 tracheostomised patients admitted from May 2020 to February 2022, compared with a cohort of non-COVID-19 tracheostomised patients. COVID-19 tracheostomised patients had a higher mortality rate (50% vs. 27.3% in non-COVID-19 patients). Mortality risk factors in COVID-19 tracheostomised patients included female sex (HR 1.99, CI 1.09-3.61, = 0.025), ischemic heart disease (HR 5.71, CI 1.59-20.53, = 0.008), elevated pre-tracheostomy values of PEEP (HR 1.06, CI 1.01-1.11, = 0.017) and INR (HR 1.04, CI 1.01-1.07, = 0.004), and ventilatory complications (HR 8.63, CI 1.09-68.26, = 0.041). No significant differences in complication rates were found based on Sars-CoV-2 infection or tracheostomy type. Tracheostomy technique did not impact complications, discharge circumstances, or mortality, supporting the safety of bedside percutaneous tracheostomies for COVID-19 patients. COVID-19 tracheostomised patients exhibited a higher mortality rate.

摘要

比较接受气管切开术的新冠肺炎患者与非新冠肺炎气管切开术患者的结局,以确定影响病情严重程度和死亡率的因素。对2020年5月至2022年2月收治的接受气管切开术的新冠肺炎患者进行了一项回顾性单中心队列研究,并与一组接受气管切开术的非新冠肺炎患者进行比较。接受气管切开术的新冠肺炎患者死亡率较高(50%,而非新冠肺炎患者为27.3%)。接受气管切开术的新冠肺炎患者的死亡风险因素包括女性(HR 1.99,CI 1.09 - 3.61,P = 0.025)、缺血性心脏病(HR 5.71,CI 1.59 - 20.53,P = 0.008)、气管切开术前PEEP值升高(HR 1.06,CI 1.01 - 1.11,P = 0.017)和INR升高(HR 1.04,CI 1.01 - 1.07,P = 0.004)以及通气并发症(HR 8.63,CI 1.09 - 68.26,P = 0.041)。基于Sars-CoV-2感染或气管切开术类型,并发症发生率无显著差异。气管切开术技术不影响并发症、出院情况或死亡率,这支持了床边经皮气管切开术对新冠肺炎患者的安全性。接受气管切开术的新冠肺炎患者死亡率较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ac9/11765842/75183325821b/jcm-14-00633-g001.jpg

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