Early Tracheostomy in Patients with Cervical Spine Injury Reduces Morbidity and Improves Resource Utilization
BACKGROUND: Aim of our study is to analyze the impact of Early Tracheostomy (ET) in patients with cervical-spine (C-spine) injuries.
METHODS: We analyzed seven-year (2010-2016) ACS-TQIP databank and included all non-TBI trauma patients diagnosed with c-spine injuries. Patients were stratified into two groups based on the timing of tracheostomy (Early; ≤7days: Late; >7days). Outcomes were complications, hospital and ICU stay. Regression analysis was performed.
RESULTS: We included 1139 patients. Mean age was 47 ± 12, median ISS was 18 [12-28], and median C-spine AIS was 4 [3-5]. 24.5% of the patients received ET. On regression analysis, patients who received ET had lower overall-complications (OR:0.57) and ventilator-associated pneumonia (OR:0.61). ET was associated with shorter duration of mechanical ventilation, and hospital and ICU stay. There was no difference in mortality rate.
CONCLUSIONS: Early tracheostomy in patients with C-spine injuries was associated with lower rates of ventilator-associated-pneumonia, shorter duration of mechanical ventilation, and ICU and hospital stay.
Khan, M., Prabhakaran, K., Jehan, F., Anderson, P., Con, J., Lombardo, G., Rhee, P., & Latifi, R. (2020). Early Tracheostomy in Patients with Cervical Spine Injury Reduces Morbidity and Improves Resource Utilization. American Journal of Surgery, 220 (3), 773-777. https://doi.org/10.1016/j.amjsurg.2020.01.054