Long-Term Survival and Medical Costs of Patients with Prolonged Mechanical Ventilation and Tracheostomy: A Nationwide Cohort Study

Lai, Hui-Hsuan; Tseng, Pei-Ying; Wang, Chenyu; Wang, Jong-Yi

doi:10.3390/ijerph181910272

Cited by 4 publications

(4 citation statements)

References 43 publications

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“…The literature indicates that COPD and pneumonia are two common reasons for ventilator dependency. Patients with COPD were not only found to have difficulty being weaned off ventilators, but COPD was also recognized as an independent risk factor for the long-term mortality of ventilator-dependent patients [ 38 ]. Our study found that comorbidities in COPD patients impacted the duration of mechanical ventilation.…”

Section: Discussionmentioning

confidence: 99%

The impact of comorbidities on prolonged mechanical ventilation in patients with chronic obstructive pulmonary disease

Liao,

Lu,

Chen

et al. 2024

BMC Pulm Med

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Background In patients with chronic obstructive pulmonary disease (COPD) and acute respiratory failure, approximately 10% of them are considered to be at high risk for prolonged mechanical ventilation (PMV, > 21 days). PMV have been identified as independent predictors of unfavorable outcomes. Our previous study revealed that patients aged 70 years older and COPD severity were at a significantly higher risk for PMV. We aimed to analyze the impact of comorbidities and their associated risks in patients with COPD who require PMV. Methods The data used in this study was collected from Kaohsiung Medical University Hospital Research Database. The COPD subjects were the patients first diagnosed COPD (index date) between January 1, 2012 and December 31, 2020. The exclusion criteria were the patients with age less than 40 years, PMV before the index date or incomplete records. COPD and non-COPD patients, matched controls were used by applying the propensity score matching method. Results There are 3,744 eligible patients with COPD in the study group. The study group had a rate of 1.6% (60 cases) patients with PMV. The adjusted HR of PMV was 2.21 (95% CI 1.44–3.40; P < 0.001) in the COPD patients than in non-COPD patients. Increased risks of PMV were found significantly for patients with diabetes mellitus (aHR 4.66; P < 0.001), hypertension (aHR 3.20; P = 0.004), dyslipidemia (aHR 3.02; P = 0.015), congestive heart failure (aHR 6.44; P < 0.001), coronary artery disease (aHR 3.11; P = 0.014), stroke (aHR 6.37; P < 0.001), chronic kidney disease (aHR 5.81 P < 0.001) and Dementia (aHR 5.78; P < 0.001). Conclusions Age, gender, and comorbidities were identified as significantly higher risk factors for PMV occurrence in the COPD patients compared to the non-COPD patients. Beyond age, comorbidities also play a crucial role in PMV in COPD.

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Section: Discussionmentioning

confidence: 99%

The impact of comorbidities on prolonged mechanical ventilation in patients with chronic obstructive pulmonary disease

Liao,

Lu,

Chen

et al. 2024

BMC Pulm Med

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“…All patients were followed for three months for adverse events related to the tracheostomy. Complications were divided into six main groups based on the literature review [5][6][7]. All information was collected on a Proforma.…”

Section: Methodsmentioning

confidence: 99%

“…When trauma to the head, neck, or upper aerodigestive tumors ensues, a prophylactic tracheostomy may be required. As a result of the surgery or radiation therapy, there is a risk that the upper airway will become blocked, and tracheostomies are recommended before starting treatment [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison Between Complications of Elective and Emergency Tracheostomies

Natasha,

Khurshied,

Zahid

et al. 2023

Cureus

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Introduction Tracheostomy, although a common surgical procedure, is associated with potential complications. Complications can be avoided with accurate technique and proper operative and postoperative care. A surgeon should know the complications of the procedure and how to avoid them so that complications may be prevented or minimized. Objective To determine the frequency of complications in patients undergoing elective and emergency tracheostomies. Methods The cross-sectional study was conducted at the Department of Otorhinolaryngology - Head and Neck Surgery, and Intensive Care Unit (ICU) of PIMS Hospital, Islamabad, from March 1 to August 31, 2023, with a total duration of six months. A total of 110 patients admitted to the ICU and presented in an emergency falling within the inclusion criteria were counted in the study. Patients were split into two groups, i.e., elective tracheostomy (group A) and emergency tracheostomy (group B). All patients were followed for three months for adverse events related to the tracheostomy. All information was collected on Proforma and analyzed using the SPSS 23 version (IBM Corp., Armonk, NY). Results The mean age of participants was 48.47±12.68 years in group A and 49.54±10.99 years in group B (p=0.636). 40 (72.7%) and 37 (67.3%) patients were male and 15 (27.3%) and 18 (32.7%) female in groups A and B, respectively. The results of post-operative complications in both groups A and B were observed, respectively, for surgical emphysema (2 [3.6%] vs. 5 [9.1%], p=0.241), hemorrhage (2 [3.6%] vs. 4 [7.3%], p=0.401), wound infection (3 [3.6%] vs. 6 [10.9%], p=0.279), tube blockage (0 [0.0%] vs. 1 [1.8%], p=0.315), tube displacement (0 [0.0%] vs. 3 [5.5%], p=0.079), and tracheoesophageal fistula (0 [0.0%] vs. 2 [3.6%], p=0.154). The overall complications in elective tracheostomies were 7 (12.7%) and in emergency tracheostomies were 21 (38.2%). Conclusion We concluded that patients who had an emergency tracheostomy experienced more postoperative complications than those who underwent an elective tracheostomy.

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“…Management of chronic diseases outside the hospital exists as a tricky issue. Meanwhile, treatment of chronic diseases is a long-term process, which requires lifelong treatment, long-term medication and health management ( Lai et al, 2021 ; Wang et al, 2021 ; Wu H. et al, 2021 ). Under the traditional medical care model, patients need to communicate with doctors about their disease in hospital.…”

Section: Introductionmentioning

confidence: 99%

Determining Factors Affecting the Users’ Participation of Online Health Communities: An Integrated Framework of Social Capital and Social Support

Tian

Wu²

2022

Front. Psychol.

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As the national awareness of health keeps deepening, online health communities (OHCs) have achieved rapid development. Users’ participation is critically important to the sustainable development of OHCs. Nevertheless, users usually lack the motive for participation. Based on the social capital theory, this research examines factors influencing users’ participation in OHCs. The purpose of this research is to find out decisive factors that influence users’ participation in OHCs, enrich the understanding of users’ participation in OHCs, and help OHCs address the issue of sustainable development. The research model was empirically tested using 1277 responses from an online survey conducted in China. Data was analyzed using the structural equation modeling (SEM). We found informational support and emotional support to have significant direct effects over the structural capital, relational capital and cognitive capital of OHCs. Meanwhile, it is observed that relational capital and cognitive capital degree have a significant influence on knowledge acquisition and knowledge contribution of OHCs. For researchers this study provides a basis for further refinement of individual models of users’ participation. For practitioners, understanding the social capital is crucial to users’ knowledge acquisition and knowledge contribution that achieve high participation in OHCs.

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Long-Term Survival and Medical Costs of Patients with Prolonged Mechanical Ventilation and Tracheostomy: A Nationwide Cohort Study

Cited by 4 publications

References 43 publications

The impact of comorbidities on prolonged mechanical ventilation in patients with chronic obstructive pulmonary disease

The impact of comorbidities on prolonged mechanical ventilation in patients with chronic obstructive pulmonary disease

Comparison Between Complications of Elective and Emergency Tracheostomies

Determining Factors Affecting the Users’ Participation of Online Health Communities: An Integrated Framework of Social Capital and Social Support

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