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Neurocritical Care
Published in: Neurocritical Care 1/2016

01-08-2016 | Original Article

The SETscore to Predict Tracheostomy Need in Cerebrovascular Neurocritical Care Patients

Authors: Silvia Schönenberger, Faisal Al-Suwaidan, Meinhard Kieser, Lorenz Uhlmann, Julian Bösel

Published in: Neurocritical Care | Issue 1/2016

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Abstract

Background and Purpose

Patients with severe stroke who require mechanical ventilation and neurointensive care unit (NICU) management often require a tracheostomy (TT). The optimal time point for TT remains unclear and a controversy in everyday NICU life. Here, we prospectively evaluated a score for prediction of TT need in NICU patients with cerebrovascular disease.

Methods

Seventy-five consecutively ventilated stroke patients were prospectively included in the study and assessed by the stroke-related early tracheostomy score (SETscore) within the first 24 h of admission. Endpoints were TT need, NICU-length of stay (NICU-LOS), and ventilation time (VT). We examined the correlation of these variables with the SETscore using regression analysis and determined a cut-off by receiver operating characteristic (ROC) analysis.

Results

Twenty-six patients had to be tracheostomized. The mean VT was 8.7 ±8 days and the mean NICU-LOS was 11.6 ± 8 days. The SETscore predicted NICU-LOS with a positive predictive value of 0.748 (p < 0.001) and VT with a positive predictive value of 0.799 (p < 0.001). The ROC analysis demonstrated a SETscore value of 8 to be the optimal cut-off to predict prolonged NICU-LOS, VT, and TT need with a sensitivity of 64 % and a specificity of 86 %.

Conclusions

Based on this monocentric study, the SETscore seems to be a valid tool to indicate prolonged NICU-LOS and VT, as well as TT need in cerebrovascular NICU patients. Confirmation of these results in larger cohorts with various settings may help to develop the SETscore as a decisive tool on primary TT early in time to avoid extubation failure.
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Metadata
Title
The SETscore to Predict Tracheostomy Need in Cerebrovascular Neurocritical Care Patients
Authors
Silvia Schönenberger
Faisal Al-Suwaidan
Meinhard Kieser
Lorenz Uhlmann
Julian Bösel
Publication date
01-08-2016
Publisher
Springer US
Published in
Neurocritical Care / Issue 1/2016
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-015-0235-5

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