| Abstract | UVOD I CILJ ISTRAŽIVANJA: Traheostomija je drevni kirurški postupak kojim se stvara otvor u dušniku radi postavljanja cijevi zbog održavanja ventilacije. Oko 10% strojno ventiliranih bolesnika zahtjeva postavljanje traheostomije. Postupak postavljanja traheostomije može biti kirurški ili perkutani. Svrha ovog istraživačkog rada je analizirati učestalost izvođenja, komplikacije i ishode u bolesnika kod kojih je učinjena perkutana dilatacijska traheostomija (PDT) u razdoblju od 1. siječnja 2022. do 31. prosinca 2023. godine koji su liječeni na Odjelu intenzivnog liječenja Klinike za anesteziologiju, intenzivnu medicinu i liječenje boli Kliničkog bolničkog centra Rijeka.
ISPITANICI I METODE: Ovo retrospektivno opservacijsko istraživanje provedeno je analizom podataka od siječnja 2022. do prosinca 2023. Cilj je bio istražiti učestalost i vrste komplikacija u bolesnika nakon PDT, kao i ishode liječenja. Podaci su prikupljeni iz bolničke baze podataka i medicinske dokumentacije, uz odobrenje Etičkog povjerenstva. Analiza je uključivala demografske podatke, komplikacije i ishode liječenja. Statistička obrada podataka izvršena je pomoću Microsoft Excela (verzija 11, Microsoft Corporation, SAD).
REZULTATI: Od 1395, PDT učinjena je kod 7,5% bolesnika. Većina bolesnika su muškarci (77%), s prosječnom dobi od 61 godinu. PDT se najčešće izvodila između 4. i 7. dana. Glavne dijagnoze bolesnika kojima je učinjena PDT su bile traumatske ozljede (36,3%) i bolesti dišnog sustava (26,5%). Komplikacije su zabilježene kod 53,1% bolesnika, što odbacuje hipotezu H2 o učestalosti komplikacija <15%. Najčešće rane komplikacije su krvarenje (14,2%), a kasne infekcije (36,3%). Preživljenje u prvih tjedan dana bilo je 83,2%, a smrtnost 16,8%. Nakon tjedan dana, smrtnost je porasla na 29,8%.
ZAKLJUČAK: Rezultati istraživanja ukazuju da je učestalost PDT 7,5%, manje od očekivanih 10%. Komplikacije su bile učestale, s incidencijom od 53,1%. Rane komplikacije uključivale su krvarenje, a kasne infekcije. Preživljenje bolesnika nakon PDT bilo je 83,2% u prvih tjedan dana, ali smrtnost je porasla na 29,8% nakon tjedan dana. Zaključno, PDT je korisna ali zahtijeva pažnju zbog komplikacija i ishod, te se preporučuje dugoročno praćenje bolesnika. |
| Abstract (english) | INTRODUCTION AND RESEARCH GOAL: Tracheostomy is an ancient surgical procedure for creating an opening in the trachea to place a tube, first illustrated in Egypt in 3600 B.C. About 10% of patients on mechanical ventilation for more than three days undergo tracheostomy. The procedure can be an open surgical intervention or a percutaneous approach. The purpose of this research paper is to analyze the frequency of performance, complications, and outcomes in patients who underwent percutaneous dilatational tracheostomy (PDT) from January 1, 2022, to December 31, 2023, treated at the Intensive Care Unit of the Clinical Hospital Center Rijeka.
RESPONDENTS AND METHODS: This retrospective observational study was conducted by analyzing data from January 2022 to December 2023. The goal was to investigate the frequency and types of complications after PDT, as well as treatment outcomes. Data were collected from the hospital database and medical records, with the approval of the Ethics Committee. The analysis included demographic data, complications, and treatment outcomes. Statistical data processing was performed using Microsoft Excel (version 11, Microsoft Corporation, USA).
RESULTS: Out of 1395 patients, PDT was performed on 7,5% of patients. Most patients were male (77%), with an average age of 61 years. PDT was most performed between the 4th and 7th day. The main diagnoses were traumatic injuries (36,3%) and respiratory system diseases (26,5%). Complications were recorded in 53,1% of patients, which rejects the hypothesis H2 about the frequency of complications <15%. The most common early complications were bleeding (14,2%), and late complications were infections (36,3%). The survival rate in the first week was 83,2%, and the mortality rate was 16,8%. After a week, the mortality rate increased to 29,8%.
CONCLUSION: The research results show that the frequency of percutaneous dilatational tracheotomy was 7,5%, less than the expected 10%. Complications were frequent, with an incidence of 53,1%. Early complications included bleeding, while late complications were infections. The survival rate after percutaneous dilatational tracheotomy was 83,2% in the first week, but mortality increased to 29,8% after a week. In conclusion, percutaneous dilatational tracheostomy is beneficial but requires attention due to complications and outcomes, and long-term monitoring of patients is recommended. |
