Synchronous tracheostomy and gastrostomy placement results in shorter length of stay in traumatic brain injury patients - 12/12/23
, Sara Soule b, Emily Lenart b, Isaac W. Howley b, Dina Filiberto b, Saskya Byerly bAbstract |
Background |
American Society for Parenteral and Enteral Nutrition (ASPEN) guidelines recommend gastrostomy for patients suspected to require enteral access device for 4–6 weeks. Our hypothesis was that traumatic brain injury (TBI) patients undergoing synchronous tracheostomy/gastrostomy (SYNC) compared to tracheostomy first (DELAY) have shorter length of stay (LOS) but higher rates of unnecessary gastrostomy.
Methods |
Retrospective review of TBI patients requiring tracheostomy in 2017–2022 at a Level 1 trauma center was conducted. SYNC and DELAY patients were compared, and CoxPH analysis was performed for LOS.
Results |
394 patients were included [mean age: 42 (SD:18); mortality: 9 %]. The DELAY group had longer LOS (39 vs 32 days, p < 0.001). There was no significant difference in unnecessary gastrostomy rate between groups (p = 0.1331). In adjusted hazard analysis, SYNC predicted shorter LOS (HR:1.54; 95 % CI:1.20–1.98, p < 0.001).
Conclusions |
Synchronous gastrostomy was associated with shorter length of stay and similar rates of unnecessary gastrostomy in TBI patients.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Patients suspected to have feeding requirement longer than 4–6 weeks should undergo gastrostomy. |
• | We examined the effect of tracheostomy with concomitant/delayed gastrostomy on length of stay. |
• | 394 patients with traumatic brain injury and tracheostomy were reviewed. |
• | Patient receiving synchronous tracheostomy/gastrostomy had shorter hospital length of stay. |
• | There was no significant difference in rates of unnecessary gastrostomy placement between groups. |
Keywords : Gastrostomy timing, Traumatic brain injury
Plan
Vol 227
P. 153-156 - janvier 2024 Retour au numéro
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