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Tracheostomy in patients with COVID-19: predictors and clinical features
BACKGROUND: Around 20% of patients hospitalized for COVID-19 need mechanical ventilation (MV). MV may be prolonged, thus warranting tracheostomy. METHODS: Observational cohort study enrolling patients admitted due to COVID-19. Demographic and clinical data at hospital and ICU admission were collecte...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775730/ https://www.ncbi.nlm.nih.gov/pubmed/33386436 http://dx.doi.org/10.1007/s00405-020-06555-x |
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author | Sancho, Jesus Ferrer, Santos Lahosa, Carolina Posadas, Tomas Bures, Enric Bañuls, Pilar Fernandez-Presa, Lucia Royo, Pablo Blasco, Mª Luisa Signes-Costa, Jaime |
author_facet | Sancho, Jesus Ferrer, Santos Lahosa, Carolina Posadas, Tomas Bures, Enric Bañuls, Pilar Fernandez-Presa, Lucia Royo, Pablo Blasco, Mª Luisa Signes-Costa, Jaime |
author_sort | Sancho, Jesus |
collection | PubMed |
description | BACKGROUND: Around 20% of patients hospitalized for COVID-19 need mechanical ventilation (MV). MV may be prolonged, thus warranting tracheostomy. METHODS: Observational cohort study enrolling patients admitted due to COVID-19. Demographic and clinical data at hospital and ICU admission were collected. The primary endpoint was to identify parameters associated with a need for tracheostomy; secondary endpoints were to analyze the clinical course of patients who needed tracheostomy. RESULTS: 118 patients were enrolled; 37 patients (31.5%) were transferred to ICU, of which 11 (29.72%) needed a tracheostomy due to prolonged MV. Sequential Organ Failure Assessment (SOFA) score at ICU admission (OR 0.65, 95% CI 0.47–0.92, p 0.015) was the only variable found to be associated with increased risk of the need for tracheostomy, with a cut-off point of 4.5 (sensitivity 0.72, specificity 0.73, positive predictive value 0.57 and negative predictive value 0.85). The main complications were nosocomial infection (100%), supraventricular cardiac arrhythmia (45.5%), agitation (54.5%), pulmonary thromboembolism (9.1%) and depression (9.1%). All patients presented with hypoalbuminemia and significant critical illness polyneuropathy. CONCLUSION: SOFA at ICU admission is associated with an increased risk of tracheostomy in patients with COVID-19. Moreover, they present clinical features similar to those with chronic critical illness and suffer SARS-CoV-2-related complications. |
format | Online Article Text |
id | pubmed-7775730 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-77757302021-01-04 Tracheostomy in patients with COVID-19: predictors and clinical features Sancho, Jesus Ferrer, Santos Lahosa, Carolina Posadas, Tomas Bures, Enric Bañuls, Pilar Fernandez-Presa, Lucia Royo, Pablo Blasco, Mª Luisa Signes-Costa, Jaime Eur Arch Otorhinolaryngol Head and Neck BACKGROUND: Around 20% of patients hospitalized for COVID-19 need mechanical ventilation (MV). MV may be prolonged, thus warranting tracheostomy. METHODS: Observational cohort study enrolling patients admitted due to COVID-19. Demographic and clinical data at hospital and ICU admission were collected. The primary endpoint was to identify parameters associated with a need for tracheostomy; secondary endpoints were to analyze the clinical course of patients who needed tracheostomy. RESULTS: 118 patients were enrolled; 37 patients (31.5%) were transferred to ICU, of which 11 (29.72%) needed a tracheostomy due to prolonged MV. Sequential Organ Failure Assessment (SOFA) score at ICU admission (OR 0.65, 95% CI 0.47–0.92, p 0.015) was the only variable found to be associated with increased risk of the need for tracheostomy, with a cut-off point of 4.5 (sensitivity 0.72, specificity 0.73, positive predictive value 0.57 and negative predictive value 0.85). The main complications were nosocomial infection (100%), supraventricular cardiac arrhythmia (45.5%), agitation (54.5%), pulmonary thromboembolism (9.1%) and depression (9.1%). All patients presented with hypoalbuminemia and significant critical illness polyneuropathy. CONCLUSION: SOFA at ICU admission is associated with an increased risk of tracheostomy in patients with COVID-19. Moreover, they present clinical features similar to those with chronic critical illness and suffer SARS-CoV-2-related complications. Springer Berlin Heidelberg 2021-01-01 2021 /pmc/articles/PMC7775730/ /pubmed/33386436 http://dx.doi.org/10.1007/s00405-020-06555-x Text en © The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Head and Neck Sancho, Jesus Ferrer, Santos Lahosa, Carolina Posadas, Tomas Bures, Enric Bañuls, Pilar Fernandez-Presa, Lucia Royo, Pablo Blasco, Mª Luisa Signes-Costa, Jaime Tracheostomy in patients with COVID-19: predictors and clinical features |
title | Tracheostomy in patients with COVID-19: predictors and clinical features |
title_full | Tracheostomy in patients with COVID-19: predictors and clinical features |
title_fullStr | Tracheostomy in patients with COVID-19: predictors and clinical features |
title_full_unstemmed | Tracheostomy in patients with COVID-19: predictors and clinical features |
title_short | Tracheostomy in patients with COVID-19: predictors and clinical features |
title_sort | tracheostomy in patients with covid-19: predictors and clinical features |
topic | Head and Neck |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775730/ https://www.ncbi.nlm.nih.gov/pubmed/33386436 http://dx.doi.org/10.1007/s00405-020-06555-x |
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