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 language | English (US) |
|---|---|
| Pages (from-to) | 257-263 |
| Number of pages | 7 |
| Journal | Annals of Otology, Rhinology and Laryngology |
| Volume | 125 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2016 |
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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 journal › Article
}
TY - JOUR
T1 - Predictors of posterior glottic stenosis
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
Y1 - 2016/3/1
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
UR - http://www.scopus.com/inward/record.url?scp=84961842165&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84961842165&partnerID=8YFLogxK
U2 - 10.1177/0003489415608867
DO - 10.1177/0003489415608867
M3 - Article
C2 - 26466860
AN - SCOPUS:84961842165
VL - 125
SP - 257
EP - 263
JO - Annals of Otology, Rhinology and Laryngology
JF - Annals of Otology, Rhinology and Laryngology
SN - 0003-4894
IS - 3
ER -