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Objective:To analyze the risk factors which may lead to tracheostomy in patients receiving invasive mechanical ventilation (IMV) in emergency intensive care unit (EICU).Methods:A case-control study was adopted to retrospectively analyze the clinical data of patients hospitalized in EICU receiving IMV from August 2016 to August 2019. The clinical data of patients were extracted through the electronic medical record system of the hospital information database. Patients were divided into the tracheostomy group and successful extubation group according to whether they received tracheostomy during hospitalization. The different clinical characteristics of the two groups were compared, and logistic regression was used to analyze the independent risk factors of tracheostomy.Results:A total of 109 patients were included in this study, among which, 53 patients underwent tracheotomy and 56 patients were successfully extubated. Logistic regression showed that GCS score ≤ 8 ( OR=5.10, 95% CI: 1.68-15.42, P < 0.01), cervical spinal cord injury ( OR=10.32, 95% CI: 2.74-38.82, P < 0.01), and sepsis ( OR=3.45, 95% CI: 1.39-8.54, P<0.01) were independent risk factors of tracheostomy for patients receiving IMV in EICU. Conclusions:If patients receiving IMV have GCS score ≤ 8, cervical spinal cord injury, or sepsis, they should be given more attention, because they may need early tracheostomy to save lives and improve the prognosis.
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Objective To investigate the incidence of aspirin resistance (AR) in patients with Type Ⅱ Diabetes mellitus (DM) and the correlation between AR and advanced glycosylation end products (AGEs) as well as the homeostasis model assessment for insulin resistance index (HOMA-IR). Methods A total of 69 patients with Type Ⅱ DM and another 23 patients without DM as control group were enrolled between October 2009 and July 2010. Blood lipid, blood routine, fasting blood glucose, Glycated hemoglobin (GHb/Hb A1c) ,fasting insulin were determined at first. After aspirin treatment for at least 7 days, platelet aggregation stimulated by arachidonic acid(AA) and adenosine diphosphate (ADP) were measured. In addition, the level of serum AGEs was measured by using ELISA assay. The degree of insulin resistance was obtained by using HOMA-IR. Results The incidence of AR in patients with Type Ⅱ DM was higher than that in the controls(30.4% vs. 8.7%, P = 0.037 ); the levels of serum AGEs and HOMA-IR in patients with Type Ⅱ DM were higher than those in the controls [ (359.56 ± 120. 14) pg/mL vs. (275.45 ± 118.06)pg/mL, P=0. 004; (4.42 ±4.78) vs. ( 1.5 ±0.78), P＜0.01, respectively]; platelet aggregation stimulated by AA in the diabetic group was correlated with serum AGEs and HOMA-IR( R =0.463, P ＜0.01; R=0.290, P =0.016, respectively); and platelet aggregation stimulated by ADP was only positively correlated with HOMA-IR(R =0.242, P = 0.045). Conclusions The incidence of AR in patients with Type Ⅱ Diabetes mellitus is higher than that in the controls, and diabetics with higher serum AGEs and HOMA-IR are more likely to develop aspirin resistant.