Journal
AMERICAN JOURNAL OF SURGERY
Volume 220, Issue 3, Pages 773-777Publisher
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjsurg.2020.01.054
Keywords
Trauma; Cervical spine injury; Tracheostomy
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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. (c) 2020 Elsevier Inc. All rights reserved.
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