RT Journal Article
SR Electronic
T1 Does aspiration have any influence on the mortality rate of patients in prolonged weaning?
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2072
VO 44
IS Suppl 58
A1 Markus Zenner
A1 Daniel Meurer
A1 Stephanie Baumann-Emmel
A1 Miriam Brand
A1 Mechthild Kulosa
A1 Gabriele Rheinbay
A1 Ute Flugel
A1 Svetlana Velikodnaia
A1 Jochem König
A1 Klaus Kienast
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P2072.abstract
AB BACKGROUND/AIM: It was our hypothesis, that tracheotomised patients with long term mechanical ventilation (LTMV) and aspiration, who had been admitted to a specialised ward in order to undergo weaning from LTMV, have a higher mortality risk.METHODS: We used a retrospective analysis of 121 medical records from our clinic. This included files from the years 2009 till 2013. Aspiration was evidenced by Evans blue dye passing through the vocal chords (VC) and detected by an endoscope passed through the tracheostoma and directed toward the VC. The statistical analysis was done using the U-test considering the duration of LTMV, age, gender, comorbidities, and other factors. Kaplan Meier curves, Log rank test and Cox regression analysis were used to analyse survival.RESULTS: 48/121 patients (40%) aspirated during the swallowing test (ST). 40/48 patients (83%) died within 4 years. Of the patients without aspiration during the ST 39/73 died (53%), p<0.001, hazard ratio 2,8 (95% confidence interval 1,8-4,5). Patients with a positive ST had a 83 % risk for subsequent aspiration, whereas pts with a negative ST had a 15 % risk for subsequent aspiration .CONCLUSION: This case series shows 40 % risk of aspiration in patients with LTMV. These pts have significant higher mortality after 4 years, and evidence for subsequent aspiration can be found in 83 %.