Analysis of factors leading to tracheostomy in patients receiving invasive mechanical ventilation in emergency intensive care unit
10.3760/cma.j.issn.1671-0282.2023.03.014
- VernacularTitle:引起急诊重症监护室内接受有创机械通气患者气管切开的因素分析
- Author:
Dongcheng SHI
1
;
Yongxia LI
;
Jiamei JIANG
;
Gang ZHAO
;
Qiming FENG
;
Wei WU
Author Information
1. 上海交通大学医学院附属第六人民医院急诊医学科，上海 200233
- Keywords:
Emergency intensive care unit;
Acute respiratory failure;
Invasive mechanical ventilation;
Tracheal intubation;
Tracheostomy
- From:
Chinese Journal of Emergency Medicine
2023;32(3):360-364
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk factors which may lead to tracheostomy in patients receiving invasive mechanical ventilation (IMV) in emergency intensive care unit (EICU).Methods:A case-control study was adopted to retrospectively analyze the clinical data of patients hospitalized in EICU receiving IMV from August 2016 to August 2019. The clinical data of patients were extracted through the electronic medical record system of the hospital information database. Patients were divided into the tracheostomy group and successful extubation group according to whether they received tracheostomy during hospitalization. The different clinical characteristics of the two groups were compared, and logistic regression was used to analyze the independent risk factors of tracheostomy.Results:A total of 109 patients were included in this study, among which, 53 patients underwent tracheotomy and 56 patients were successfully extubated. Logistic regression showed that GCS score ≤ 8 ( OR=5.10, 95% CI: 1.68-15.42, P < 0.01), cervical spinal cord injury ( OR=10.32, 95% CI: 2.74-38.82, P < 0.01), and sepsis ( OR=3.45, 95% CI: 1.39-8.54, P<0.01) were independent risk factors of tracheostomy for patients receiving IMV in EICU. Conclusions:If patients receiving IMV have GCS score ≤ 8, cervical spinal cord injury, or sepsis, they should be given more attention, because they may need early tracheostomy to save lives and improve the prognosis.
