https://scholars.lib.ntu.edu.tw/handle/123456789/560717
Title: | The importance of tracheostomy to the weaning success in patients with conscious disturbance in the respiratory care center | Authors: | Lee Y.-C. HAO-CHIEN WANG CHIA-LIN HSU HUEY-DONG WU Hsu H.-S. Kuo C.-D. |
Issue Date: | 2016 | Journal Volume: | 79 | Journal Issue: | 2 | Start page/Pages: | 72-76 | Source: | Journal of the Chinese Medical Association | Abstract: | Background: When to extubate the endotracheal tube is controversial in patients with depressed mental status. The use of the Glasgow Coma Scale (GCS) with score 8 or above as a criterion for extubation by many investigators is questionable. Methods: A total of 133 consecutive patients (M/F: 86/47; age: 71 ± 17 years) admitted to the respiratory care center (RCC) of the hospital were enrolled. The effects of GCS score on the outcomes and weaning rate of the patients were evaluated. Results: The mortality rate was significantly higher in patients with a GCS score. <. 7T or derived GCS (dGCS) score < 10 (p = 0.011). In patients with a low GCS score (GCS < 7T or dGCS score < 10), the rate of successful ventilator weaning in patients with tracheostomy was significantly higher than that in patients without tracheostomy (GCS and dGCS: 94.4% vs. 38.5%, p = 0.001). However, tracheostomy in patients with a high GCS (GCS score ? 7T or dGCS score ? 10) did not lead to a higher success rate of weaning. In multivariable analysis, tracheostomy was still an independent determinant of successful weaning in patients with low GCS. Conclusion: Tracheostomy increases the success rate of weaning in patients with low GCS, but not in patients with high GCS. Mental status graded by GCS did affect the outcomes in patients with conscious disturbance in the RCC. The low tracheostomy rate in patients with low GCS affected the rate of successful weaning, which might have contributed to the higher mortality rate in patients with low GCS in the RCC. ? 2015. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/560717 | ISSN: | 1726-4901 | DOI: | 10.1016/j.jcma.2015.10.004 | SDG/Keyword: | aged; Article; artificial ventilation; consciousness disorder; controlled study; female; Glasgow coma scale; human; major clinical study; male; mathematical analysis; multivariate analysis; respiratory care; scoring system; statistical analysis; tracheostomy; extubation; middle aged; statistical model; very elderly; Aged; Aged, 80 and over; Airway Extubation; Female; Glasgow Coma Scale; Humans; Logistic Models; Male; Middle Aged; Tracheostomy |
Appears in Collections: | 醫學院附設醫院 (臺大醫院) |
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