Predictors of posterior glottic stenosis: A multi-institutional case-control study

Alexander Tell Hillel, Selmin Karatayli-Ozgursoy, Idris Samad, Simon R Best, Vinciya Pandian, Laureano Giraldez, Jennifer Gross, Christopher Wootten, Alexander Gelbard, Lee M Akst, Michael M. Johns

Research output: Contribution to journalArticle

Abstract

Objective: To assess intrinsic and extrinsic risk factors in the development of posterior glottic stenosis (PGS) in intubated patients. Methods: Patients diagnosed with PGS between September 2012 and May 2014 at 3 tertiary care university hospitals were included. Patient demographics, comorbidities, duration of intubation, endotracheal tube (ETT) size, and indication for intubation were recorded. Patients with PGS were compared to control patients represented by patients intubated in intensive care units (ICU). Results: Thirty-six PGS patients were identified. After exclusion, 28 PGS patients (14 male, 14 female) and 112 (65 male, 47 female) controls were studied. Multivariate analysis demonstrated ischemia (P <.05), diabetes (P <.01), and length of intubation (P <.01) were significant risk factors for the development of PGS. Fourteen of 14 (100%) males were intubated with a size 8 or larger ETT compared to 47 of 65 (72.3%) male controls (P <.05). Posterior glottic stenosis (P <.01), length of intubation (P <.001), and obstructive sleep apnea (P <.05) were significant risk factors for tracheostomy. Conclusion: Duration of intubation, ischemia, diabetes mellitus, and large ETT size (8 or greater) in males were significant risk factors for the development of PGS. Reducing the use of size 8 ETTs and earlier planned tracheostomy in high-risk patients may reduce the incidence of PGS and improve ICU safety.

Original languageEnglish (US)
Pages (from-to)257-263
Number of pages7
JournalAnnals of Otology, Rhinology and Laryngology
Volume125
Issue number3
DOIs
StatePublished - Mar 1 2016

Fingerprint

Tongue
Case-Control Studies
Pathologic Constriction
Intubation
Tracheostomy
Intensive Care Units
Ischemia
Intratracheal Intubation
Obstructive Sleep Apnea
Tertiary Healthcare
Comorbidity
Diabetes Mellitus
Multivariate Analysis
Demography
Safety
Incidence

Keywords

  • Fibrosis
  • Hospital safety
  • Intubation
  • Laryngotracheal stenosis
  • Tracheostomy

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Predictors of posterior glottic stenosis : A multi-institutional case-control study. / Hillel, Alexander Tell; Karatayli-Ozgursoy, Selmin; Samad, Idris; Best, Simon R; Pandian, Vinciya; Giraldez, Laureano; Gross, Jennifer; Wootten, Christopher; Gelbard, Alexander; Akst, Lee M; Johns, Michael M.

In: Annals of Otology, Rhinology and Laryngology, Vol. 125, No. 3, 01.03.2016, p. 257-263.

Research output: Contribution to journalArticle

Hillel, Alexander Tell ; Karatayli-Ozgursoy, Selmin ; Samad, Idris ; Best, Simon R ; Pandian, Vinciya ; Giraldez, Laureano ; Gross, Jennifer ; Wootten, Christopher ; Gelbard, Alexander ; Akst, Lee M ; Johns, Michael M. / Predictors of posterior glottic stenosis : A multi-institutional case-control study. In: Annals of Otology, Rhinology and Laryngology. 2016 ; Vol. 125, No. 3. pp. 257-263.
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abstract = "Objective: To assess intrinsic and extrinsic risk factors in the development of posterior glottic stenosis (PGS) in intubated patients. Methods: Patients diagnosed with PGS between September 2012 and May 2014 at 3 tertiary care university hospitals were included. Patient demographics, comorbidities, duration of intubation, endotracheal tube (ETT) size, and indication for intubation were recorded. Patients with PGS were compared to control patients represented by patients intubated in intensive care units (ICU). Results: Thirty-six PGS patients were identified. After exclusion, 28 PGS patients (14 male, 14 female) and 112 (65 male, 47 female) controls were studied. Multivariate analysis demonstrated ischemia (P <.05), diabetes (P <.01), and length of intubation (P <.01) were significant risk factors for the development of PGS. Fourteen of 14 (100{\%}) males were intubated with a size 8 or larger ETT compared to 47 of 65 (72.3{\%}) male controls (P <.05). Posterior glottic stenosis (P <.01), length of intubation (P <.001), and obstructive sleep apnea (P <.05) were significant risk factors for tracheostomy. Conclusion: Duration of intubation, ischemia, diabetes mellitus, and large ETT size (8 or greater) in males were significant risk factors for the development of PGS. Reducing the use of size 8 ETTs and earlier planned tracheostomy in high-risk patients may reduce the incidence of PGS and improve ICU safety.",
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T2 - A multi-institutional case-control study

AU - Hillel, Alexander Tell

AU - Karatayli-Ozgursoy, Selmin

AU - Samad, Idris

AU - Best, Simon R

AU - Pandian, Vinciya

AU - Giraldez, Laureano

AU - Gross, Jennifer

AU - Wootten, Christopher

AU - Gelbard, Alexander

AU - Akst, Lee M

AU - Johns, Michael M.

PY - 2016/3/1

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N2 - Objective: To assess intrinsic and extrinsic risk factors in the development of posterior glottic stenosis (PGS) in intubated patients. Methods: Patients diagnosed with PGS between September 2012 and May 2014 at 3 tertiary care university hospitals were included. Patient demographics, comorbidities, duration of intubation, endotracheal tube (ETT) size, and indication for intubation were recorded. Patients with PGS were compared to control patients represented by patients intubated in intensive care units (ICU). Results: Thirty-six PGS patients were identified. After exclusion, 28 PGS patients (14 male, 14 female) and 112 (65 male, 47 female) controls were studied. Multivariate analysis demonstrated ischemia (P <.05), diabetes (P <.01), and length of intubation (P <.01) were significant risk factors for the development of PGS. Fourteen of 14 (100%) males were intubated with a size 8 or larger ETT compared to 47 of 65 (72.3%) male controls (P <.05). Posterior glottic stenosis (P <.01), length of intubation (P <.001), and obstructive sleep apnea (P <.05) were significant risk factors for tracheostomy. Conclusion: Duration of intubation, ischemia, diabetes mellitus, and large ETT size (8 or greater) in males were significant risk factors for the development of PGS. Reducing the use of size 8 ETTs and earlier planned tracheostomy in high-risk patients may reduce the incidence of PGS and improve ICU safety.

AB - Objective: To assess intrinsic and extrinsic risk factors in the development of posterior glottic stenosis (PGS) in intubated patients. Methods: Patients diagnosed with PGS between September 2012 and May 2014 at 3 tertiary care university hospitals were included. Patient demographics, comorbidities, duration of intubation, endotracheal tube (ETT) size, and indication for intubation were recorded. Patients with PGS were compared to control patients represented by patients intubated in intensive care units (ICU). Results: Thirty-six PGS patients were identified. After exclusion, 28 PGS patients (14 male, 14 female) and 112 (65 male, 47 female) controls were studied. Multivariate analysis demonstrated ischemia (P <.05), diabetes (P <.01), and length of intubation (P <.01) were significant risk factors for the development of PGS. Fourteen of 14 (100%) males were intubated with a size 8 or larger ETT compared to 47 of 65 (72.3%) male controls (P <.05). Posterior glottic stenosis (P <.01), length of intubation (P <.001), and obstructive sleep apnea (P <.05) were significant risk factors for tracheostomy. Conclusion: Duration of intubation, ischemia, diabetes mellitus, and large ETT size (8 or greater) in males were significant risk factors for the development of PGS. Reducing the use of size 8 ETTs and earlier planned tracheostomy in high-risk patients may reduce the incidence of PGS and improve ICU safety.

KW - Fibrosis

KW - Hospital safety

KW - Intubation

KW - Laryngotracheal stenosis

KW - Tracheostomy

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