論文

査読有り 国際誌
2018年12月

Tracheostomy and mortality in patients with severe burns: A nationwide observational study.

Burns : journal of the International Society for Burn Injuries
  • Asuka Tsuchiya
  • ,
  • Hayato Yamana
  • ,
  • Takuya Kawahara
  • ,
  • Yusuke Tsutsumi
  • ,
  • Hiroki Matsui
  • ,
  • Kiyohide Fushimi
  • ,
  • Hideo Yasunaga

44
8
開始ページ
1954
終了ページ
1961
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.burns.2018.06.012

BACKGROUND: Tracheostomy is often performed in patients with severe burns who are undergoing prolonged mechanical ventilation. However, the appropriate timing of tracheostomy and its effect on mortality remain unknown. The aim of this study was to determine whether tracheostomy can reduce mortality in patients with severe burns. METHODS: Using the Japanese Diagnosis Procedure Combination database from April 2010 to March 2014, we extracted data on adult patients with severe burns (burn index score of ≥15) who started mechanical ventilation within 3days of admission. We estimated the hazard ratio for 28-day in-hospital mortality associated with tracheotomy performed from day 5 to 28. We adjusted for baseline and time-dependent confounders using inverse probability of treatment weighting methods and fitted a marginal structural Cox proportional hazard model. RESULTS: We identified 680 eligible patients (94 in the tracheostomy group, 2289 person-days; 586 in the non-tracheostomy group, 11,197 person-days). Patients who underwent a tracheostomy had worse prognostic factors for mortality. After adjustment for these factors, the hazard ratio for 28-day mortality associated with tracheostomy compared with non-tracheostomy was 0.73 (95% confidence interval, 0.39-1.34). CONCLUSIONS: There was no significant association between 28-day in-hospital mortality and early tracheostomy in adult patients with severe burns.

リンク情報
DOI
https://doi.org/10.1016/j.burns.2018.06.012
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/29980328
ID情報
  • DOI : 10.1016/j.burns.2018.06.012
  • PubMed ID : 29980328

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