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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/29663


    標題: Tracheostomy versus Endotracheal Intubation Prior to Admission to a Respiratory Care Center: A Retrospective Analysis
    作者: Tseng, Kuei-Ling
    Shieh, Jiunn-Min
    Cheng, Kuo-Chen
    Chiang, Kuo-Hwa
    Chiang, Shyh-Ren
    Ko, Shiann-Chin
    Cheng, Ai-Chin
    Chen, Chin-Ming
    貢獻者: 通識教育中心
    休閒保健管理系
    關鍵字: outcome
    prolonged mechanical ventilation
    respiratory care center
    tracheostomy
    weaning
    日期: 2015-09
    上傳時間: 2016-04-19 19:03:47 (UTC+8)
    出版者: Elsevier Taiwan
    摘要: Background: This study was conducted to examine the hypothesis that a tracheostomy prior to admission to a respiratory care center (RCC) with a specialized weaning setting would improve the outcome of patients transferred from intensive care unit previously maintained on prolonged mechanical ventilation.Methods: A retrospective review of medical records from intubated adult patients admitted to the ChiMei Medical Center, a 16-bed RCC in Southern Taiwan from January 1, 2001 through July 31, 2012, was performed. The outcomes at weaning (without ventilator support within 120 hours), mortality, and expenditure at hospital discharge were compared between the tracheostomy group (n = 1216) and the endotracheal tube group (n = 1187), and the predictors of weaning in all patients were determined.Results: The overall weaning rate and the in-hospital mortality rate were 68.2% and 16.4%, respectively. The tracheostomy group showed significantly higher weaning rate and shorter hospital stay (73.5% vs. 62.8% and 57.4 vs. 61.0 days, both p < 0.01) compared with the endotracheal tube group. In-hospital mortality, total ventilator days, and cost of hospitalization were comparable between groups. Factors predictive of successful weaning were surgical origin [odds ratio (OR) 2.165], higher albumin (OR 1.937), tracheostomy group (OR 1.543), higher PaO2/fraction of inspired oxygen (OR 1.345), and lower blood urea nitrogen (OR 0.984).Conclusion: Tracheostomy creation prior to RCC admission was associated with a significantly higher weaning rate and reduced hospital stays. The provision of assessment of the aforementioned markers may be helpful in the clinical setting to facilitate the optimal management and the accreditation of medical care quality of patients with prolonged mechanical ventilation. Copyright 2015, Taiwan Society of Geriatric Emergency & Critical Care Medicine. Published by Elsevier Taiwan LLC. All rights reserved.
    關聯: International Journal of Gerontology, v.9 n.3, pp.151-155
    Appears in Collections:[休閒保健管理系(所)] 期刊論文
    [通識教育中心] 期刊論文

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