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:6/26/2016)... ... June 27, 2016 , ... Quality metrics are proliferating in ... ways they remain in the eye of the beholder, according to experts who offered ... The American Journal of Managed Care. For the full issue, click here . ...
(Date:6/26/2016)... ... June 26, 2016 , ... Pixel Film Studios Released ProSlice Levels, a Media ... give their videos a whole new perspective by using the title layers in ... Studios. , ProSlice Levels contains over 30 Different presets to choose from. ...
(Date:6/26/2016)... ... , ... Brent Kasmer, a legally blind and certified personal trainer is helping to develop a ... fitness app plans to fix the two major problems leading the fitness industry today:, ... type program , They don’t eliminate all the reasons people quit their exercise ...
(Date:6/25/2016)... ... June 25, 2016 , ... ... issues and applications at AcademyHealth’s Annual Research Meeting June 26-28, 2016, at the ... several important health care topics including advance care planning, healthcare costs and patient ...
(Date:6/25/2016)... ... , ... The temporary closing of Bruton Memorial Library on June 21 due to a possible ... often overlooked aspect of head lice: the parasite’s ability to live away from a human ... but a necessary one in the event that lice have simply gotten out of control. ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... Research and Markets has announced the addition of ... their offering. The current ... environment for MedImmune to enter. The US ageing population creates ... drive considerable growth for effective anti-influenza medications. The introduction of ... but development is still in its infancy. ...
(Date:6/23/2016)... the establishment of Astellas Farma Colombia (AFC), a new affiliate with operations headquartered in Bogota. Colombia ... ... Sandra ... ... Astellas is a pharmaceutical company ...
(Date:6/23/2016)... Research and Markets has announced the addition ... States, China, Japan, Brazil, United Kingdom, Germany, France, Italy, ... Surgical Procedure Volumes: Global ... surgical procedure volume data in a geographic context. The ... of growth drivers and inhibitors, including world population growth, ...
Breaking Medicine Technology: