Muhammad Khan1, Kartik Prabhakaran2, Faisal Jehan3, Patrice Anderson4, Jorge Con5, Gary Lombardo6, Peter Rhee7, Rifat Latifi8. 1. Department of Surgery, Westchester Medical Center-New York Medical College Valhalla New York, USA. Electronic address: Muhammad.khan@wmchealth.org. 2. Section of Trauma and Acute Care Surgery, Department of Surgery, Westchester Medical Center-New York Medical College Valhalla New York, USA. Electronic address: Kartik.Prabhakaran@wmchealth.org. 3. Department of Surgery, Westchester Medical Center-New York Medical College Valhalla New York, USA. Electronic address: Faisal.Jehan@wmchealth.org. 4. Section of Trauma and Acute Care Surgery, Department of Surgery, Westchester Medical Center-New York Medical College Valhalla New York, USA. Electronic address: PatriceLynn.Anderson@wmchealth.org. 5. Section of Trauma and Acute Care Surgery, Department of Surgery, Westchester Medical Center-New York Medical College Valhalla New York, USA. Electronic address: Jorge.Con@wmchealth.org. 6. Section of Trauma and Acute Care Surgery, Department of Surgery, Westchester Medical Center-New York Medical College Valhalla New York, USA. Electronic address: Gary.Lombardo@wmchealth.org. 7. Section of Trauma and Acute Care Surgery, Department of Surgery, Westchester Medical Center-New York Medical College Valhalla New York, USA. Electronic address: Peter.Rhee@wmchealth.org. 8. Section of Trauma and Acute Care Surgery, Department of Surgery, Westchester Medical Center-New York Medical College Valhalla New York, USA. Electronic address: Rifat.Latifi@wmchealth.org.
Abstract
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.
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-TBItraumapatients 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.