Predicting the need for tracheostomy in trauma patients without severe head injury - 20/06/20
, Asad Azim b , Muhammad Khan b , Faisal Jehan b , James Feeney c, ⁎ , Patrice Anderson d , Anthony Policastro e , Rifat Latifi f Abstract |
Background |
Early tracheostomy is recommended in patients with severe traumatic brain injury (TBI); however, predicting the timing of tracheostomy in trauma patients without severe TBI can be challenging.
Methods |
A one year retrospective analysis of all trauma patients who were admitted to intensive Care Unit for > 7 days was performed, using the ACS-TQIP database. Univariate and Multivariate regression analyses were performed to assess the appropriate weight of each factor in determining the eventual need for early tracheostomy.
Results |
A total of 21,663 trauma patients who met inclusion and exclusion criteria were identified. Overall, tracheostomy was performed in 18.3% of patients. On multivariate regression analysis age >70, flail chest, major operative intervention, ventilator days >5 days and underlying COPD were independently associated with need of tracheostomy. Based on these data, we developed a scoring system to predict risk for requiring tracheostomy.
Conclusion |
Age >70, presence of flail chest, need for major operative intervention, ventilator days >5 and underlying COPD are independent predictors of need for tracheostomy in trauma patients without severe TBI.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Predicting the need for tracheostomy in trauma patients can improve resource utilization. |
• | Presently, tracheostomy is recommended only for patients with severe traumatic brain injury. |
• | A model can predict the need for tracheostomy in trauma patients without severe traumatic brain injury. |
Keywords : Tracheostomy, Traumatic brain injury, TQIP, Trauma, Scoring system
Plan
Vol 220 - N° 2
P. 495-498 - août 2020 Retour au numéro
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