Timing of tracheostomy in geriatric patients with isolated severe traumatic brain injury: A nationwide analysis

IF 2.7 3区医学 Q1 SURGERY American journal of surgery Pub Date : 2024-11-22 DOI:10.1016/j.amjsurg.2024.116100

Omar I. Morales Rosario , Emanuele Lagazzi , Vahe S. Panossian , Josip Plascevic , Yasmin Arda , May Abiad , Ikemsinachi Nzenwa , George C. Velmahos , John O. Hwabejire

{"title":"Timing of tracheostomy in geriatric patients with isolated severe traumatic brain injury: A nationwide analysis","authors":"Omar I. Morales Rosario , Emanuele Lagazzi , Vahe S. Panossian , Josip Plascevic , Yasmin Arda , May Abiad , Ikemsinachi Nzenwa , George C. Velmahos , John O. Hwabejire","doi":"10.1016/j.amjsurg.2024.116100","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The impact of tracheostomy timing on outcomes is unclear in geriatric patients with traumatic brain injury (TBI).</div></div><div><h3>Methods</h3><div>Patients aged≥65 with isolated severe TBI who underwent tracheostomy were identified in the ACS-TQIP 2017–2020 database. Patients were grouped by early (<10 days) vs. late (≥10 days) tracheostomy. Propensity score matching accounted for confounders. Outcomes included mortality, hospital (H-LOS) and ICU length of stay (ICU-LOS), ventilator days, and complications.</div></div><div><h3>Results</h3><div>Among 1385 patients, 637 (46.0 %) had an early tracheostomy. Following propensity score matching, early tracheostomy was associated with shorter H-LOS (18 vs. 25 days, p < 0.001), ICU-LOS (14 vs. 20 days, p < 0.001), and fewer ventilator days (12 vs. 17 days, p < 0.001). Furthermore, the incidence of deep vein thrombosis was lower in the early tracheostomy group (6.7 % vs. 11.3 %, p = 0.024), but mortality rates were similar (11.1 % vs. 9.5 %, p = 0.48).</div></div><div><h3>Conclusion</h3><div>Early tracheostomy in geriatric patients with isolated severe TBI is associated with reduced LOS, ventilator days, and complications, suggesting potential benefits of earlier intervention.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"240 ","pages":"Article 116100"},"PeriodicalIF":2.7000,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0002961024006524","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

The impact of tracheostomy timing on outcomes is unclear in geriatric patients with traumatic brain injury (TBI).

Methods

Patients aged≥65 with isolated severe TBI who underwent tracheostomy were identified in the ACS-TQIP 2017–2020 database. Patients were grouped by early (<10 days) vs. late (≥10 days) tracheostomy. Propensity score matching accounted for confounders. Outcomes included mortality, hospital (H-LOS) and ICU length of stay (ICU-LOS), ventilator days, and complications.

Results

Among 1385 patients, 637 (46.0 %) had an early tracheostomy. Following propensity score matching, early tracheostomy was associated with shorter H-LOS (18 vs. 25 days, p < 0.001), ICU-LOS (14 vs. 20 days, p < 0.001), and fewer ventilator days (12 vs. 17 days, p < 0.001). Furthermore, the incidence of deep vein thrombosis was lower in the early tracheostomy group (6.7 % vs. 11.3 %, p = 0.024), but mortality rates were similar (11.1 % vs. 9.5 %, p = 0.48).

Conclusion

Early tracheostomy in geriatric patients with isolated severe TBI is associated with reduced LOS, ventilator days, and complications, suggesting potential benefits of earlier intervention.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

老年孤立性严重脑外伤患者的气管切开时机：全国性分析

背景在老年创伤性脑损伤（TBI）患者中，气管切开时间对预后的影响尚不明确。方法在 ACS-TQIP 2017-2020 数据库中识别了年龄≥65 岁、接受气管切开术的孤立性严重 TBI 患者。患者按早期（<10 天）与晚期（≥10 天）气管切开术分组。倾向评分匹配考虑了混杂因素。结果包括死亡率、住院时间（H-LOS）和重症监护室住院时间（ICU-LOS）、呼吸机使用天数和并发症。结果在1385名患者中，637人（46.0%）接受了早期气管切开术。经过倾向评分匹配，早期气管切开术与缩短 H-LOS （18 天 vs. 25 天，p < 0.001）、ICU-LOS（14 天 vs. 20 天，p < 0.001）和减少呼吸机天数（12 天 vs. 17 天，p < 0.001）有关。此外，早期气管切开组的深静脉血栓发生率较低（6.7 % vs. 11.3 %，p = 0.024），但死亡率相似（11.1 % vs. 9.5 %，p = 0.48）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.

期刊最新文献

A systematic review of the use of GLP-1 receptor agonists in surgery Appendectomy, acute appendicitis, and gastrointestinal diseases: A Mendelian randomization study Timing of tracheostomy in geriatric patients with isolated severe traumatic brain injury: A nationwide analysis Editorial Board Table of Contents (5pgs)