Tracheostomy practice and timing in traumatic brain-injured patients: a CENTER-TBI study
dc.contributor.author | Robba, Chiara | |
dc.contributor.author | Galimberti, Stefania | |
dc.contributor.author | Graziano, Francesca | |
dc.contributor.author | Wiegers, E | |
dc.contributor.author | Lingsma, Hester F | |
dc.contributor.author | Iaquaniello, Carolina | |
dc.contributor.author | Stocchetti, Nino | |
dc.contributor.author | Menon, David | |
dc.contributor.author | Citerio, Giuseppe | |
dc.contributor.author | Andelic, Nada | |
dc.contributor.author | Andreassen, Lasse | |
dc.contributor.author | Anke, Audny | |
dc.contributor.author | Lund, Stine Borgen | |
dc.contributor.author | Frisvold, Shirin | |
dc.contributor.author | Helseth, Eirik | |
dc.contributor.author | Røe, Cecilie | |
dc.contributor.author | Røise, Olav | |
dc.contributor.author | Sandrød, Oddrun | |
dc.contributor.author | Schirmer-Mikalsen, Kari | |
dc.contributor.author | Vik, Anne | |
dc.contributor.author | Åkerlund, Cecilia | |
dc.contributor.author | Amrein, Krisztina | |
dc.contributor.author | Audibert, Gerard | |
dc.contributor.author | Azouvi, Philippe | |
dc.contributor.author | Azzolini, Maria Luisa | |
dc.contributor.author | Bartels, Ronald | |
dc.contributor.author | Beer, Ronny | |
dc.contributor.author | Bellander, Bo-Michael | |
dc.contributor.author | Benali, Habib | |
dc.contributor.author | Berardino, Maurizio | |
dc.contributor.author | Beretta, Luigi | |
dc.contributor.author | Biqiri, Erta | |
dc.contributor.author | Blaabjerg, Morten | |
dc.contributor.author | Brorsson, Camilla | |
dc.contributor.author | Buki, Andras | |
dc.contributor.author | Cabeleira, Manuel | |
dc.contributor.author | Caccioppola, Alessio | |
dc.contributor.author | Calappi, Emiliana | |
dc.contributor.author | Calvi, Maria Rosa | |
dc.contributor.author | Cameron, Peter | |
dc.contributor.author | Lozano, Guillermo Carbayo | |
dc.contributor.author | Carbonara, Marco | |
dc.contributor.author | Castaño-León, Ana M. | |
dc.contributor.author | Chevallard, Giorgio | |
dc.contributor.author | Chieregato, Arturo | |
dc.contributor.author | Coburn, Mark | |
dc.contributor.author | Coles, Jonathan | |
dc.contributor.author | Cooper, Jamie | |
dc.contributor.author | Correia, Marta | |
dc.contributor.author | Czeiter, Endre | |
dc.date.accessioned | 2021-03-22T08:44:46Z | |
dc.date.available | 2021-03-22T08:44:46Z | |
dc.date.created | 2020-09-06T16:18:08Z | |
dc.date.issued | 2020 | |
dc.identifier.citation | Intensive Care Medicine. 2020, 46 983-994. | en_US |
dc.identifier.issn | 0342-4642 | |
dc.identifier.uri | https://hdl.handle.net/11250/2734673 | |
dc.description.abstract | Purpose Indications and optimal timing for tracheostomy in traumatic brain-injured (TBI) patients are uncertain. This study aims to describe the patients’ characteristics, timing, and factors related to the decision to perform a tracheostomy and differences in strategies among different countries and assess the effect of the timing of tracheostomy on patients’ outcomes. Methods We selected TBI patients from CENTER-TBI, a prospective observational longitudinal cohort study, with an intensive care unit stay ≥ 72 h. Tracheostomy was defined as early (≤ 7 days from admission) or late (> 7 days). We used a Cox regression model to identify critical factors that affected the timing of tracheostomy. The outcome was assessed at 6 months using the extended Glasgow Outcome Score. Results Of the 1358 included patients, 433 (31.8%) had a tracheostomy. Age (hazard rate, HR = 1.04, 95% CI = 1.01–1.07, p = 0.003), Glasgow coma scale ≤ 8 (HR = 1.70, 95% CI = 1.22–2.36 at 7; p < 0.001), thoracic trauma (HR = 1.24, 95% CI = 1.01–1.52, p = 0.020), hypoxemia (HR = 1.37, 95% CI = 1.05–1.79, p = 0.048), unreactive pupil (HR = 1.76, 95% CI = 1.27–2.45 at 7; p < 0.001) were predictors for tracheostomy. Considerable heterogeneity among countries was found in tracheostomy frequency (7.9–50.2%) and timing (early 0–17.6%). Patients with a late tracheostomy were more likely to have a worse neurological outcome, i.e., mortality and poor neurological sequels (OR = 1.69, 95% CI = 1.07–2.67, p = 0.018), and longer length of stay (LOS) (38.5 vs. 49.4 days, p = 0.003). Conclusions Tracheostomy after TBI is routinely performed in severe neurological damaged patients. Early tracheostomy is associated with a better neurological outcome and reduced LOS, but the causality of this relationship remains unproven. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Springer | en_US |
dc.title | Tracheostomy practice and timing in traumatic brain-injured patients: a CENTER-TBI study | en_US |
dc.type | Peer reviewed | en_US |
dc.type | Journal article | en_US |
dc.description.version | publishedVersion | en_US |
dc.source.pagenumber | 983-994 | en_US |
dc.source.volume | 46 | en_US |
dc.source.journal | Intensive Care Medicine | en_US |
dc.identifier.doi | 10.1007/s00134-020-05935-5 | |
dc.identifier.cristin | 1827575 | |
dc.relation.project | Norges forskningsråd: 272789 | en_US |
dc.relation.project | EU/602150 | en_US |
dc.description.localcode | This article will not be available due to copyright restrictions © 2020 by Springer | en_US |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 |