Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/29915
Title: Factors associated with short versus prolonged tracheostomy length of cannulation and the relationship between length of cannulation and adverse events
Austin Authors: Zaga, Charissa J ;Sweeney, Joanne, M;Cameron, Tanis, S;Campbell, Matthew, C;Warrillow, Stephen, J;Howard, Mark, E
Affiliation: Department of Speech Pathology, Allied Health Division, Austin Health, Heidelberg, Victoria, Australia
Tracheostomy Review and Management Service, Allied Health Division, Austin Health, Heidelberg, Victoria, Australia
Institute of Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
Department of Ear, Nose and Throat Surgery, Austin Health, Heidelberg, Victoria, Australia
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 3-Nov-2021
Publication information: Australian critical care : official journal of the Confederation of Australian Critical Care Nurses 2021-11-03
Abstract: Tracheostomy management and care is multifaceted and costly, commonly involving complex patients with prolonged hospitalisation. Currently, there are no agreed definitions of short and prolonged length of tracheostomy cannulation (LOC) and no consensus regarding the key factors that may be associated with time to decannulation. The aims of this study were to identify the factors associated with short and prolonged LOC and to examine the number of tracheostomy-related adverse events of patients who had short LOC versus prolonged LOC. A retrospective observational study was undertaken at a large metropolitan tertiary hospital. Factors known at the time of tracheostomy insertion, including patient, acuity, medical, airway, and tracheostomy factors, were analysed using Cox proportional hazards model and Kaplan-Meier survival curves, with statistically significant factors then analysed using univariate logistic regression to determine a relationship to short or prolonged LOC as defined by the lowest and highest quartiles of the study cohort. The number of tracheostomy-related adverse events was analysed using the Kaplan-Meier survival curve. One hundred twenty patients met the inclusion criteria. Patients who had their tracheostomy performed for loss of upper airway were associated with short LOC (odds ratio [OR]: 2.30 (95% confidence interval [CI]: 1.01-5.25) p = 0.049). Three factors were associated with prolonged LOC: an abdominal/gastrointestinal tract diagnosis (OR: 5.00 [95% CI: 1.40-17.87] p = 0.013), major surgery (OR: 2.51 [95% CI: 1.05-6.01] p = 0.038), and intubation for >12 days (OR: 0.30 [95% CI: 0.09-0.97] p = 0.044). Patients who had one or ≥2 tracheostomy-related adverse events had a high likelihood of prolonged LOC (OR: 5.21 [95% CI: 1.95-13.94] p = ≤0.001 and OR: 12.17 [95% CI: 2.68-55.32] p ≤ 0.001, respectively). Some factors that are known at the time of tracheostomy insertion are associated with duration of tracheostomy cannulation. Tracheostomy-related adverse events are related to a high risk of prolonged LOC.
URI: https://ahro.austin.org.au/austinjspui/handle/1/29915
DOI: 10.1016/j.aucc.2021.09.003
Type: Journal Article
Subjects: Adverse events
Decannulation
Length of cannulation
Tracheostomy
Appears in Collections:Journal articles

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