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World Journal of Surgery

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01-06-2018 | Original Scientific Report

Early Versus Late Tracheostomy in Trauma Patients: A Propensity-Matched Cohort Study of 5 Years’ Data at a Single Institution in Korea

Authors: Byung Hee Kang, Jayun Cho, John Cook-Jong Lee, Kyoungwon Jung

Published in: World Journal of Surgery | Issue 6/2018

Abstract

Background

Although there have been many studies dealing with tracheostomy timing in trauma patients, the optimal timing is still being debated. This study aimed to compare outcomes between early tracheostomy (ET) and late tracheostomy (LT) in trauma populations to estimate the optimal timing of tracheostomy after intubation.

Methods

We retrospectively reviewed the 5 years’ data of trauma patients who underwent tracheostomy during their acute intensive care unit (ICU) stay. The cases were divided into two groups: ET was defined as tracheostomy performed within 7 days after intubation, and LT, after the seventh day. Propensity score matching was utilized using a 1-to-1 matching technique, and outcomes between two groups were compared.

Results

Among 236 enrolled patients, 76 met the criteria for ET and 160 were included for LT. Using propensity matching, 70 patients who met the criteria for ET were matched to 70 patients in the LT. Based on the comparison of outcomes after matching, ET showed significantly shorter values than LT in overall ventilator duration, length of stay at the ICU, and post-tracheostomy ventilation duration. Furthermore, the incidence of pneumonia was significantly lower with ET than with LT, although the rate of postoperative complications showed no significant differences.

Conclusions

We suggest that ET should be considered in trauma patients needing prolonged mechanical ventilation. Also, we recommend that surgeons perform tracheostomy as early as within 7 days after intubation to not only reduce the ventilation and ICU days but also prevent pneumonia without worrying about an increase in postoperative complications.

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Title: Early Versus Late Tracheostomy in Trauma Patients: A Propensity-Matched Cohort Study of 5 Years’ Data at a Single Institution in Korea
Authors: Byung Hee Kang
Jayun Cho
John Cook-Jong Lee
Kyoungwon Jung
Publication date: 01-06-2018
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 6/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-018-4474-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Early Versus Late Tracheostomy in Trauma Patients: A Propensity-Matched Cohort Study of 5 Years’ Data at a Single Institution in Korea

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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