Objective To explore the risk factors for tracheal stenosis caused by tracheotomy or intubation.Methods From July 2010 to July 2020, a total of 44 patients were suffered with tracheal stenosis caused by tracheotomy or intubation at the First Affiliated Hospital of Hunan Normal University as case group (n=44), and 34 patients were suffered tracheotomy or intubation without tracheal stenosis as control group (n=34). The clinical application of intratracheal tube cuff diameter was investigated by univariate comparison, ROC analysis and multivariate logistic regression analysis.Results Univariate analysis showed intratracheal tube cuff diameter (C)/transverse diameter at the level of the clavicle >150%, intubation time>7d, tracheal intubations/tracheostomy ≥2, recurrent respiratory tract infections and replacement of tracheal tube≥ 2 were the influence factors of posttracheostomy tracheal stenosis (PTTS) and postintubation tracheal stenosis (PITS) (P<0.005). Multivariate Logistic regression analysis showed C/T>150% (OR=6.681, 95%CI: 1.164 - 38.363), intubation time>7d (OR=4.723, 95%CI: 1.413 - 15.779), tracheal intubations/tracheostomy ≥2 (OR=4.526, 95%CI: 1.133 - 18.083) and recurrent respiratory tract infections (OR=3.681, 95%CI: 1.177 - 11.513) were positively correlated with PTTS and PITS. The area under the ROC curve (AUC) of C/T>150% was 0.665 with the sensitivity of 0.364 and the specificity of 0.033 (95%CI: 0.555 - 0.775). AUC of intubation time>7 d was 0.717 with the sensitivity of 0.568 and the specificity of 0.133 (95%CI: 0.613 - 0.821). AUC of tracheal intubations/tracheostomy ≥2 was 0.683 with the sensitivity of 0.432 and the specificity of 0.067 (95%CI: 0.574 - 0.791). AUC of recurrent respiratory tract infections was 0.707 with the sensitivity of 0.614 and the specificity of 0.200 (95%CI: 0.603 - 0.811). However, there was no statistically significant difference C/T>150% and those clinical data in Z test (Z=0.839, P=0.402; Z=0.302, P=0.763; Z=0.751, P=0.453).Conclusion Intubation time>7 d, tracheal intubations/tracheostomy ≥2, recurrent respiratory tract infections, replacement of tracheal tube≥ 2 and C/T>150% are risk factors for PTTS and PITS.

Citation： LUO Rou, TAN Jianlong, LIU Zhiguang. The risk factors of posttracheostomy tracheal stenosis and postintubation tracheal stenosis. Chinese Journal of Respiratory and Critical Care Medicine, 2021, 20(5): 330-334. doi: 10.7507/1671-6205.202010069 Copy

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