Benefits of Bedside Open Tracheostomy: A Safe and Cost-Effective Alternative to the Operating Room.

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2024-10-03 DOI:10.1002/hed.27948

Arianna Winchester, David Strum, Arman Saeedi, Nupur Bhatt, Michael Chow, Ghayoour Mir, Adam Jacobson

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Abstract

Introduction: Tracheostomy is a commonly performed procedure in Otolaryngology and can be performed in different settings. We evaluate patient characteristics and cost efficacy of tracheostomy at the bedside versus operating room (OR).

Materials and methods: Retrospective chart review was performed for adult intensive care unit (ICU) patients who underwent tracheostomy from 2020 to 2023. Data and cost of procedures were analyzed using descriptive statistics.

Results: One hundred and sixty-five patients were included. One hundred and thirty-four (81.2%) patients underwent bedside tracheostomy. Age, sex, and BMI were not significantly different. Average time from consult to procedure and operative time was significantly shorter (p = 0.03; 0.008). There were no differences in postoperative complications, 30-day mortality, ICU length of stay (LOS), or overall LOS. Tracheostomy at the bedside offered a 73.1% cost reduction compared with performed in the OR.

Conclusion: Advantages of bedside tracheostomy include decreased operative time, time from consult to procedure, and cost reduction for the hospital system. We advocate for consideration of bedside tracheostomy when appropriate.

Level of evidence: 4:

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床旁开放式气管造口术的优点：手术室之外安全、经济的替代方案。

简介：气管造口术是耳鼻喉科常用的手术，可在不同环境下进行。我们评估了床旁气管切开术与手术室气管切开术的患者特征和成本效益：我们对 2020 年至 2023 年期间接受气管切开术的成人重症监护病房（ICU）患者进行了回顾性病历审查。采用描述性统计对数据和手术费用进行了分析：结果：共纳入 165 名患者。134名患者（81.2%）接受了床旁气管切开术。年龄、性别和体重指数无明显差异。从问诊到手术的平均时间和手术时间明显更短（P = 0.03; 0.008）。术后并发症、30 天死亡率、重症监护室住院时间（LOS）或总住院时间均无差异。与在手术室进行气管切开术相比，床旁气管切开术的成本降低了73.1%：结论：床旁气管切开术的优点包括缩短手术时间、从会诊到手术的时间以及降低医院系统的成本。我们主张在适当的时候考虑床旁气管切开术：4:

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.