scholarly journals Tracheostomy in 80 COVID-19 Patients: A Multicenter, Retrospective, Observational Study

2020 ◽  
Vol 7 ◽  
Author(s):  
Yun Tang ◽  
Yongran Wu ◽  
Fangfang Zhu ◽  
Xiaobo Yang ◽  
Chaolin Huang ◽  
...  
Keyword(s):  
Observational Study ◽  
Clinical Characteristics ◽  
Prolonged Mechanical Ventilation ◽  
Retrospective Observational Study ◽  
Optimal Timing ◽  
Common Complication ◽  
Demographic Information ◽  
Early Tracheostomy ◽  
Number Of Patients ◽  
Successful Weaning

Background: The outbreak of coronavirus disease 2019 (COVID-19) has led to a large and increasing number of patients requiring prolonged mechanical ventilation and tracheostomy. The indication and optimal timing of tracheostomy in COVID-19 patients are still unclear, and the outcomes about tracheostomy have not been extensively reported. We aimed to describe the clinical characteristics and outcomes of patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia who underwent elective tracheostomies.Methods: The multi-center, retrospective, observational study investigated all the COVID-19 patients who underwent elective tracheostomies in intensive care units (ICUs) of 23 hospitals in Hubei province, China, from January 8, 2020 to March 25, 2020. Demographic information, clinical characteristics, treatment, details of the tracheostomy procedure, successful weaning after tracheostomy, and living status were collected and analyzed. Data were compared between early tracheostomy patients (tracheostomy performed within 14 days of intubation) and late tracheostomy patients (tracheostomy performed after 14 days).Results: A total of 80 patients were included. The median duration from endotracheal intubation to tracheostomy was 17.5 [IQR 11.3–27.0] days. Most tracheotomies were performed by ICU physician [62 (77.5%)], and using percutaneous techniques [63 (78.8%)] at the ICU bedside [76 (95.0%)]. The most common complication was tracheostoma bleeding [14 (17.5%)], and major bleeding occurred in 4 (5.0%) patients. At 60 days after intubation, 31 (38.8%) patients experienced successful weaning from ventilator, 17 (21.2%) patients discharged from ICU, and 43 (53.8%) patients had died. Higher 60 day mortality [22 (73.3%) vs. 21 (42.0%)] were identified in patients who underwent early tracheostomy.Conclusions: In patients with SARS-CoV-2 pneumonia, tracheostomies were feasible to conduct by ICU physician at bedside with few major complications. Compared with tracheostomies conducted after 14 days of intubation, tracheostomies within 14 days were associated with an increased mortality rate.

scholarly journals Tracheostomy in 80 COVID-19 patients: a multicenter, retrospective, observational study

2020 ◽  
Author(s):  
Yun Tang ◽  
Yongran Wu ◽  
Fangfang Zhu ◽  
Xiaobo Yang ◽  
Chaolin Huang ◽  
...  
Keyword(s):  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Observational Study ◽  
Endotracheal Intubation ◽  
Median Duration ◽  
Clinical Characteristics ◽  
Demographic Information ◽  
Early Tracheostomy ◽  
Successful Weaning ◽  
Icu Physicians

Abstract The aim of our study was to describe the clinical characteristics and outcomes of patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia who underwent elective tracheostomies. We investigated all COVID-19 patients who underwent elective tracheostomies in intensive care units (ICUs) of 23 hospitals in Hubei Province, China, from January 8, 2020 to March 25, 2020. Demographic information, clinical characteristics, treatment, details of the tracheostomy procedure, successful weaning after tracheostomy, and living status were collected and analyzed. A total of 80 patients were included. The median duration from endotracheal intubation to tracheostomy was 17.5 [IQR 11.3-27.0] days. Most tracheotomies were performed by ICU physicians (62 (77.5%)) and using percutaneous techniques (63 (78.8%)) at the ICU bedside (76 (95.0%)). At 60 days after intubation, 31 (38.8%) patients experienced successful weaning from the ventilator, 17 (21.2%) patients were discharged from the ICU, and 43 (53.8%) patients had died. Higher 60-day mortality (22 (73.3%) vs 21 (42.0%)) was identified in patients who underwent early tracheostomy. In patients with SARS-CoV-2 pneumonia, tracheostomies were feasible to conduct by ICU physicians at bedside with few major complications. However, tracheostomies within 14 days of endotracheal intubation should be avoided.

scholarly journals Clinical characteristics of hypertrophic herpes simplex genitalis and treatment outcomes of imiquimod: a retrospective observational study

2015 ◽  
Vol 33 ◽  
pp. 165-170 ◽  
Author(s):  
Charussri Leeyaphan ◽  
Theetat M. Surawan ◽  
Pornchai Chirachanakul ◽  
Nuntida Prasertworonun ◽  
Praewphan Punyaratabandhu ◽  
...  
Keyword(s):  
Herpes Simplex ◽  
Observational Study ◽  
Treatment Outcomes ◽  
Clinical Characteristics ◽  
Retrospective Observational Study

scholarly journals Clinical characteristics and outcomes of measles outbreak in adults: A multicenter retrospective observational study of 93 hospitalized adults in Greece

2020 ◽  
Vol 131 ◽  
pp. 104608
Author(s):  
Paraskevi C. Fragkou ◽  
Konstantinos Thomas ◽  
Styliani Sympardi ◽  
George D. Liatsos ◽  
Maria Pirounaki ◽  
...  
Keyword(s):  
Observational Study ◽  
Clinical Characteristics ◽  
Retrospective Observational Study ◽  
Measles Outbreak

scholarly journals Initial experience with novel CGRP-receptor inhibitor therapy in Migraine in the United Arab Emirates: a retrospective observational study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bui Bao Khanh Dinh ◽  
Waseem Hamed Aziz ◽  
Alessandro Terruzzi ◽  
Derk Wolfgang Krieger
Keyword(s):  
Observational Study ◽  
Odds Ratio ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Real Life ◽  
Retrospective Observational Study ◽  
Lower Probability ◽  
P Value ◽  
Cgrp Receptor ◽  
Number Of Patients

Abstract Background Erenumab is a calcitonin gene-related peptide (CGRP)-receptor antibody inhibiting CGRP function. CGRP is prominently involved in the pathophysiology of migraine through nociceptive modulation in the trigeminovascular system. This study aims to explore the treatment effect of erenumab in a real-life setting. Methods In this retrospective observational study, we analyzed the data of 91 patients with migraine receiving at least three consecutive monthly injections of erenumab and followed up for 3–12 months. The primary objective was to describe the reduction in monthly migraine days throughout the follow-up period. To identify patients who responded to treatment, we analyzed the association between different patient characteristics and their treatment outcomes. Results Seventy-three patients (80.2%) responded to erenumab treatment, defined as ≥50% reduction of migraine days per month, across all migraine types. It was noted that ethnicity (p-value = 0.015) and older age (p-value = 0.035) were associated with clinically relevant improvement of symptoms. Middle Eastern ethnicity was related to less improvement of symptoms while Europeans were more likely to benefit from erenumab therapy (odds ratio: 12.788, p = 0.037). Patients aged from 31 to 40 and 41–65 years benefited most from erenumab treatment with a response rate of 77.8 and 89.9%, respectively, also confirmed by logistic regression (p = 0.047). Neither gender nor dose increase of erenumab showed association with the reported clinically relevant improvement of the symptoms. An association between clinically relevant improvement of headaches and the type of migraine was also noted. Around 87.9% of patients with episodic migraine responded to treatment, followed by 84.1% of chronic migraine patients and 50% of medication overuse headache patients. Medication overuse headache showed a lower probability of therapy success with erenumab (odds ratio: 0.126, p = 0.039). An improvement of headaches was eminent in patients who received 140 mg erenumab monthly (2 × 70 mg injections) and patients who had one injection every two weeks. Conclusions Erenumab is a novel preventive treatment for all migraine types. Clinically relevant improvement of headaches and reduction of monthly migraine days were demonstrated in patients that continued the treatment course. In real-life, a substantial number of patients suspended therapy early, reasons for which need further investigation.

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