年龄对单层与多层气道损伤的影响:多机构综述。

IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY
Chanticha Laohakittikul, Inderpreet Kaur Khalsa, Shambavi J Rao, Steven D Stockton, Lyndsay L Madden, Daniel J Cates, VyVy N Young
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引用次数: 0

摘要

目的:研究单层气道受限和多层气道受限情况下年龄与治疗效果之间的关系:研究设计: 多机构回顾性队列研究:多机构回顾性队列研究:地点:三级喉科中心:参与者包括患有声门后狭窄(PGS)、多层次气道狭窄(MLAS)和双侧声带麻痹(BVFP)的年轻人(18-64 岁)和老年人(≥65 岁)。研究人员还描述了亚组的人口统计学特征、合并症、气道损伤的类型和病因。评估了年龄与主要结果变量(即气管造口术和气管切开率、手术次数、手术间隔时间以及患者报告的生活质量结果指标 [PROMs] 的变化)之间的相关性。统计分析包括独立 t 检验、χ2 检验、费雪精确检验或曼-惠尼检验:在 158 名患者中[96 名年轻患者(30 名 PGS、29 名 MLAS、37 名 BVFP)和 62 名老年患者(24 名 PGS、9 名 MLAS、29 名 BVFP)],年轻组与老年组在性别(P = .990)、气管造口置入率(70% vs 66%,P = .629)或拔管成功率(40% vs 24%,P = .091)方面的年龄差异不显著。在年轻患者中,MLAS 更常见(30.2% 对 14.5%,P = .024),而 BVFP 患者更有可能解除封管(50% 对 12%,P = .017)。老年患者更可能有放射治疗史(26% vs 10%,P = .016)、恶性肿瘤导致的狭窄(23% vs 9%,P = .022)和较少的总体手术次数(中位数 1 vs 3,P = .003)。各年龄亚组的PROMs中位数相当(P > .05):结论:年轻成人接受的手术次数较多,但各组间的总体合并症、气管切开取栓率和PROMs相当。年龄不会对治疗结果产生负面影响,也不应成为治疗决策的阻碍因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of Age in Single-Level Versus Multilevel Airway Compromise: A Multi-Institutional Review.

Objective: Examine the association between age and treatment outcomes in conditions causing single- versus multilevel airway restriction.

Study design: Multi-institutional retrospective cohort study.

Setting: Tertiary laryngology centers.

Methods: Participants included younger (18-64 years) and geriatric (≥65 years) adults with posterior glottic stenosis (PGS), multilevel airway stenosis (MLAS), and bilateral vocal fold paralysis (BVFP). Subgroup demographics, comorbidities, type, and etiology of airway compromise were described. Associations between age and primary outcome variables (i.e., tracheostomy and decannulation rates, number of surgeries performed, time between surgeries, and change in quality-of-life patient-reported outcome measures [PROMs]) were evaluated. Statistical analyses included independent t tests, χ2, Fisher's exact, or Mann-Whitney tests.

Results: In 158 patients [96 younger (30 PGS, 29 MLAS, 37 BVFP) and 62 geriatric (24 PGS, 9 MLAS, 29 BVFP)], age differences were not significant for gender (P = .990), tracheostomy placement (70% vs 66%, P = .629), or decannulation success (40% vs 24%, P = .091) in younger versus geriatric groups, respectively. In younger patients, MLAS was more common (30.2% vs 14.5%, P = .024), and BVFP patients were more likely to decannulate (50% vs 12%, P = .017). Geriatric patients were more likely to have a history of prior radiation (26% vs 10%, P = .016), stenosis due to malignancy (23% vs 9%, P = .022), and fewer overall surgeries (median 1 vs 3, P = .003). Median PROMs were comparable between age subgroups (P > .05).

Conclusion: Younger adults underwent more surgeries, but overall comorbidities, tracheostomy decannulation rates, and PROMs were comparable between groups. Age does not negatively impact treatment outcomes and should not be a deterrent in treatment decision-making.

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来源期刊
Otolaryngology- Head and Neck Surgery
Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学
CiteScore
6.70
自引率
2.90%
发文量
250
审稿时长
2-4 weeks
期刊介绍: Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
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