Navigation Links
Earlier tracheostomies result in better patient outcomes
Date:10/5/2011

A tracheostomy performed within the first seven days after a severe head injury results in better overall patient outcome, according to a team of Penn State College of Medicine researchers. This is especially true for patients who have a greater chance of surviving when admitted to the hospital.

A tracheostomy is an opening created in the front of the neck directly into the trachea to allow unimpeded breathing. (A tracheotomy is the act of making that opening.)

"The CDC estimates that more than 200,000 individuals are hospitalized annually for traumatic brain injury," said Kevin M. Cockroft, M.D., associate professor, neurosurgery. "Severely head-injured patients, particularly those with additional injuries, often require tracheostomy at some point during their hospital stay."

Previous studies have shown mixed results.

"Traditionally, tracheostomy, or 'trach,' has been recommended to prevent airway complications," Cockroft said. "Early trach has been advocated as a means to improve outcome, with various studies suggesting that it may decrease the incidence of pneumonia, reduce intensive care unit days and shorten overall length of stay. Some evidence also exists to suggest that early trach does not improve outcomes. As a result, the timing of trach in these critically ill patients remains controversial."

Early trach patients are defined as those who have a tracheostomy performed during the first seven hospital-stay days. Late trach patients are defined as those who have a tracheostomy performed at greater than seven days after admission.

Researchers used data collected from January 1990 through December 2005 by the Pennsylvania Trauma Society Foundation for its statewide trauma registry. Because of a lack of patients with only head injury, researchers looked at patients with injury to at least one other body system. In total, 3,104 patients were included in the study, with 1,577 in the early trach group and 1,527 in the late trach group. It is the largest study to date to report the effects of tracheostomy timing on outcome after a severe head injury.

In the study population, later trach patients were in the hospital three times longer than early trach patients and also spent an average of four times longer in the ICU. Early trach patients were 1.5 times more likely to be discharged in an independent state. However, later trach patients were twice as likely to live to be discharged from the hospital, potentially because more severe cases would receive an earlier trach.

In addition, later trach patients were about twice as likely to suffer from an adverse pulmonary occurrence such as pneumonia, about 1.5 times as likely to suffer a cardiac event such as a heart attack, and 1.5 times more likely to have an infection.

Researchers reported their results in the journal Neurocritical Care. The project was funded by the Departments of Neurosurgery and Public Health Sciences, Penn State Milton S. Hershey Medical Center and Penn State College of Medicine.

"These results indicate a complex relationship between tracheostomy timing and outcome, but suggest that a strategy of early tracheostomy, particularly when performed on patients with a reasonable chance of survival, results in a better overall clinical outcome than when the tracheostomy is performed in a delayed manner," Cockroft said.


'/>"/>

Contact: Matthew Solovey
msolovey@hmc.psu.edu
717-531-8606
Penn State
Source:Eurekalert

Related medicine news :

1. Do Men Need Colon Cancer Screening Earlier Than Women Do?
2. Hip Fracture May Raise a Womans Risk of Earlier Death
3. African-American women develop functional challenges earlier than others
4. Test could detect breast cancers earlier in young, high-risk African-American women
5. Women With BRCA Mutations Get Cancer Diagnosis Earlier Than Before
6. Women who inherit BRCA gene mutations develop cancer earlier than their ancestors
7. Breast cancer patients with BRCA gene diagnosed almost 8 years earlier than generation before
8. Boys Mature Sexually Earlier Than Ever Before: Study
9. Contrary to earlier findings, excess body fat in elderly decreases life expectancy
10. Updating family history of cancer associated with need for earlier or more intense cancer screening
11. Earlier exit from hospital after hip operation
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... ... ... On Friday, June 10, Van Mitchell, Secretary of the Maryland Department of Health ... of their exemplary accomplishments in worksite health promotion. , The Wellness at Work Awards ... at the BWI Marriott in Linthicum Heights. iHire was one of 42 businesses to ...
(Date:6/24/2016)... ... June 24, 2016 , ... Those who have experienced traumatic events ... turn to unhealthy avenues, such as drug or alcohol abuse, as a coping mechanism. ... tools for healthy coping following a traumatic event. , Trauma sufferers tend to feel ...
(Date:6/24/2016)... ... June 24, 2016 , ... The Pulmonary Hypertension ... that it will receive two significant new grants to support its work to ... its 25th anniversary by recognizing patients, medical professionals and scientists for their work ...
(Date:6/24/2016)... ... , ... Comfort Keepers® of San Diego, CA is excited to announce they ... to drive cancer patients to and from their cancer treatments. Comfort Keepers provides ... life and ongoing independence. Getting to and from medical treatments is one of ...
(Date:6/24/2016)... ... 2016 , ... EB Medicine presented its first-ever “Issue of ... in Ponte Vedra Beach, FL. The awards honor the outstanding work of leading ... and Pediatric Emergency Medicine Practice. , “With this award, we recognize the efforts ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... INDIANAPOLIS , June 23, 2016 Roche ... received 510(k) clearance for its Elecsys BRAHMS PCT (procalcitonin) ... severe sepsis or septic shock. With this clearance, Roche ... provide a fully integrated solution for sepsis risk assessment ... associated with bacterial infection and PCT levels in blood ...
(Date:6/23/2016)... -- Bracket , a leading clinical trial technology and ... platform, Bracket eCOA (SM) 6.0, at the 52 nd ... 2016 in Philadelphia , Pennsylvania.  A demonstration ... of its kind to fully integrate with RTSM, will be ... is a flexible platform for electronic clinical outcomes assessments that ...
(Date:6/23/2016)... , June 23, 2016 ... Oticon , industry leaders in advanced ... launch of Oticon Opn ™, the world,s first ... of possibilities for IoT devices.      (Photo: ... Oticon introduces a number of ,world firsts,: ...
Breaking Medicine Technology: