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Big data: Airway management at a university hospital over 16 years; a retrospective analysis

PURPOSE: Little is known about the current practice of airway management in Germany and its development over the last decades. The present study was, therefore, designed to answer the following questions. Which airway management procedures have been performed over the last 16 years and how has the f...

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Autores principales: Hummel, Regina, Wollschläger, Daniel, Baldering, Hans-Jürgen, Engelhard, Kristin, Wittenmeier, Eva, Epp, Katharina, Pirlich, Nina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9488754/
https://www.ncbi.nlm.nih.gov/pubmed/36126076
http://dx.doi.org/10.1371/journal.pone.0273549
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author Hummel, Regina
Wollschläger, Daniel
Baldering, Hans-Jürgen
Engelhard, Kristin
Wittenmeier, Eva
Epp, Katharina
Pirlich, Nina
author_facet Hummel, Regina
Wollschläger, Daniel
Baldering, Hans-Jürgen
Engelhard, Kristin
Wittenmeier, Eva
Epp, Katharina
Pirlich, Nina
author_sort Hummel, Regina
collection PubMed
description PURPOSE: Little is known about the current practice of airway management in Germany and its development over the last decades. The present study was, therefore, designed to answer the following questions. Which airway management procedures have been performed over the last 16 years and how has the frequency of these procedures changed over time? Is there a relationship between patient characteristics or surgical specialisation and the type of airway management performed? METHODS: In the present study, we used our in-house data acquisition and accounting system to retrospectively analyse airway management data for all patients who underwent a surgical or medical procedure with anaesthesiological care at our tertiary care facility over the past 16 years. 340,748 airway management procedures were analysed by type of procedure, medical/surgical specialty, and type of device used. Logistic regression was used to identify trends over time. RESULTS: Oral intubation was the most common technique over 16 years (65.7%), followed by supraglottic airway devices (18.1%), nasal intubation (7.5%), mask ventilation (1.6%), tracheal cannula (1.3%), double lumen tube (0.7%), and jet ventilation (0.6%). On average, the odds ratio of using supraglottic airway devices increased by 17.0% per year (OR per year = 1.072, 95% CI = 1.071–1.088) while oral intubation rates decreased. In 2005, supraglottic airway devices were used in about 10% of all airway management procedures. Until 2020, this proportion steadily increased by 27%. Frequency of oral intubation on the other hand decreased and was about 75% in 2005 and 53% in 2020. Over time, second-generation supraglottic airway devices were used more frequently than first-generation supraglottic airway devices. While second-generation devices made up about 9% of all supraglottic airway devices in 2010, in 2020 they represented a proportion of 82%. The use of fibreoptic intubation increased over time in otorhinolaryngology and dental, oral, and maxillofacial surgery, but showed no significant trends over the entire 16-year period. CONCLUSION: Our data represent the first large-scale evaluation of airway management procedures over a long time. There was a significant upward trend in the use of supraglottic airway devices, with an increase in the use of second-generation masks while a decrease in oral intubations was observed.
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spelling pubmed-94887542022-09-21 Big data: Airway management at a university hospital over 16 years; a retrospective analysis Hummel, Regina Wollschläger, Daniel Baldering, Hans-Jürgen Engelhard, Kristin Wittenmeier, Eva Epp, Katharina Pirlich, Nina PLoS One Research Article PURPOSE: Little is known about the current practice of airway management in Germany and its development over the last decades. The present study was, therefore, designed to answer the following questions. Which airway management procedures have been performed over the last 16 years and how has the frequency of these procedures changed over time? Is there a relationship between patient characteristics or surgical specialisation and the type of airway management performed? METHODS: In the present study, we used our in-house data acquisition and accounting system to retrospectively analyse airway management data for all patients who underwent a surgical or medical procedure with anaesthesiological care at our tertiary care facility over the past 16 years. 340,748 airway management procedures were analysed by type of procedure, medical/surgical specialty, and type of device used. Logistic regression was used to identify trends over time. RESULTS: Oral intubation was the most common technique over 16 years (65.7%), followed by supraglottic airway devices (18.1%), nasal intubation (7.5%), mask ventilation (1.6%), tracheal cannula (1.3%), double lumen tube (0.7%), and jet ventilation (0.6%). On average, the odds ratio of using supraglottic airway devices increased by 17.0% per year (OR per year = 1.072, 95% CI = 1.071–1.088) while oral intubation rates decreased. In 2005, supraglottic airway devices were used in about 10% of all airway management procedures. Until 2020, this proportion steadily increased by 27%. Frequency of oral intubation on the other hand decreased and was about 75% in 2005 and 53% in 2020. Over time, second-generation supraglottic airway devices were used more frequently than first-generation supraglottic airway devices. While second-generation devices made up about 9% of all supraglottic airway devices in 2010, in 2020 they represented a proportion of 82%. The use of fibreoptic intubation increased over time in otorhinolaryngology and dental, oral, and maxillofacial surgery, but showed no significant trends over the entire 16-year period. CONCLUSION: Our data represent the first large-scale evaluation of airway management procedures over a long time. There was a significant upward trend in the use of supraglottic airway devices, with an increase in the use of second-generation masks while a decrease in oral intubations was observed. Public Library of Science 2022-09-20 /pmc/articles/PMC9488754/ /pubmed/36126076 http://dx.doi.org/10.1371/journal.pone.0273549 Text en © 2022 Hummel et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Hummel, Regina
Wollschläger, Daniel
Baldering, Hans-Jürgen
Engelhard, Kristin
Wittenmeier, Eva
Epp, Katharina
Pirlich, Nina
Big data: Airway management at a university hospital over 16 years; a retrospective analysis
title Big data: Airway management at a university hospital over 16 years; a retrospective analysis
title_full Big data: Airway management at a university hospital over 16 years; a retrospective analysis
title_fullStr Big data: Airway management at a university hospital over 16 years; a retrospective analysis
title_full_unstemmed Big data: Airway management at a university hospital over 16 years; a retrospective analysis
title_short Big data: Airway management at a university hospital over 16 years; a retrospective analysis
title_sort big data: airway management at a university hospital over 16 years; a retrospective analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9488754/
https://www.ncbi.nlm.nih.gov/pubmed/36126076
http://dx.doi.org/10.1371/journal.pone.0273549
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