Analysis of pre-admission risk factors for unplanned reintubation in geriatric trauma patients

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2024-07-31 DOI:10.1016/j.amjsurg.2024.115882

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引用次数: 0

Abstract

Introduction

Reintubation in unplanned scenarios, carries inherent risks and potential complications particularly in vulnerable populations such as geriatric trauma patients. We sought to identify preadmission risk factors for unplanned re-intubation (URI) in geriatric trauma patients and its effects on outcomes.

Methods

Analysis of TQIP (2017–2019) of intubated geriatric trauma patients, classified into two groups, those who were successfully extubated and those who required URI. We used logistic regression to assess for preadmission risk factors of URI.

Results

Among 23,572 patients, 20.2 % underwent URI. URI had higher mortality (13.7%vs.8.1 %, p < 0.001), in-hospital complications (p < 0.05), longer hospital and ICU LOS (p < 0.001 for both). Higher age (OR = 1.017), smoking (OR = 1.418), CRF(OR = 1.414), COPD (OR = 1.410), alcohol use (OR = 1.365), functionally dependent health status (OR = 1.339), and anticoagulant use (OR = 1.148), increased the risks of URI (p < 0.05 for all).

Conclusion

Geriatric patients with comorbidities including age, smoking, CRF, COPD, alcohol use, dependent status, and anticoagulant use are at higher risks of URI that could in turn, be associated with increased rates of mortality, complications, and longer hospital and ICU length of stay.

Level of evidence

Level III retrospective study.

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老年创伤患者入院前意外再次插管的风险因素分析。

简介意外情况下的再插管具有固有风险和潜在并发症，尤其是在老年创伤患者等弱势群体中。我们试图确定老年创伤患者入院前意外再次插管（URI）的风险因素及其对治疗效果的影响：对TQIP（2017-2019年）中插管的老年创伤患者进行分析，将其分为两组，即成功拔管的患者和需要URI的患者。我们使用逻辑回归评估入院前尿毒症风险因素：在 23,572 名患者中，20.2% 的患者接受了尿路切开术。尿崩症患者的死亡率较高（13.7% 对 8.1%，P 结论：尿崩症患者的死亡率较高：合并症包括年龄、吸烟、CRF、慢性阻塞性肺病、酗酒、依赖状态和使用抗凝血剂的老年患者发生尿毒症的风险较高，这可能与死亡率、并发症、住院时间和重症监护室住院时间的延长有关：III级回顾性研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.