Predicting the Need for Early Tracheostomy: A Multifactorial Analysis of 992 Intubated Trauma Patients

Goettler, Claudia E.; Fugo, Jonathan R.; Bard, Michael R.; Newell, Mark A.; Sagraves, Scott G.; Toschlog, Eric A.; Schenarts, Paul J.; Rotondo, Michael F.

doi:10.1097/01.ta.0000217270.16860.32

Cited by 63 publications

(67 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patients with C-SCI are at increased risk of respiratory failure that may lead to the need for tracheostomy [6,11,13,15,21]. Pulmonary complications are the most common complications in patients with C-SCI [7,9].…”

Section: Discussionmentioning

confidence: 99%

“…Patients with respiratory failure after C-SCI will require intubation and mechanical ventilation, leading to tracheostomy. It has been reported that 21-77 % of patients with C-SCI have undergone tracheostomy [6,11,13,15,21].…”

Section: Discussionmentioning

confidence: 99%

“…Tracheostomy provides a secure airway, facilitates secretion control and decreases the risk of pulmonary complications in C-SCI patients [4,5,6,11,13,15,16,20,21]. It has been reported that 21-77 % of patients with C-SCI require tracheostomy [6,11,13,15,21].…”

Section: Introductionmentioning

confidence: 99%

“…It has been reported that 21-77 % of patients with C-SCI require tracheostomy [6,11,13,15,21]. Early tracheostomy has been advocated from the viewpoint of medical economics and the patient's prognosis because it decreases the length of the hospital/intensive care unit stay and the rate of infectious complications, and increases the patient's ventilation tolerance [4,5,13,16,20,21]. However, quick identification of the risk factors associated with tracheostomy for each patient is necessary for early tracheostomy, but the identification process is difficult.…”

Section: Introductionmentioning

confidence: 99%

“…However, quick identification of the risk factors associated with tracheostomy for each patient is necessary for early tracheostomy, but the identification process is difficult. Several risk factors frequently associated with tracheostomy after C-SCI, such as the severity and the level of neurological damage, age and other traumas, have been reported; however, the question of risk factors is still a controversial one [6,13,15].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Characterizing the need for tracheostomy placement and decannulation after cervical spinal cord injury

et al. 2013

View full text Add to dashboard Cite

Purpose There have been few reports on the risk factors for tracheostomy and the possibility of patients for decannulation. The purpose of this study was to identify factors necessitating tracheostomy after cervical spinal cord injury (SCI) and detect features predictive of successful decannulation in tracheostomy patients. Methods One hundred and sixty four patients with cervical fracture/dislocation were retrospectively reviewed. The patients comprised 142 men and 22 women with a mean age of 44.9 years. The clinical records were reviewed for patients' demographic data, smoking history, level of cervical spine injury, injury patterns, neurological status, evidence of direct thoracic trauma and head injury, tracheostomy placement, and decannulation. Risk factors necessitating tracheostomy and factors predicting decannulation were statistically analysed. Results Twenty-five patients (15.2 %) required tracheostomy. Twenty-one patients were successfully decannulated. Smoking history (relative risk [RR], 3.05; p = 0.03) and complete SCI irrespective of injury level (C1-4 complete SCI: RR, 67.55; p \ 0.001, C5-7 complete SCI: RR, 57.88; p \ 0.001) were significant risk factors necessitating tracheostomy. C1-4 complete SCI was more frequent among those who could not be decannulated. However, even in patients with high cervical complete SCI at the time of injury, patients regaining sufficient movement to shrug their shoulders within 3 weeks after injury could later be decannulated. Conclusions The risk factors for tracheostomy after complete SCI were a history of smoking and complete paralysis irrespective of the level of injury. High cervical level complete SCI was found to be a risk factor for the failure of decannulation in patients without shoulder shrug within 3 weeks after injury.

show abstract