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dc.contributor.authorRobba, Chiara
dc.contributor.authorGalimberti, Stefania
dc.contributor.authorGraziano, Francesca
dc.contributor.authorWiegers, E
dc.contributor.authorLingsma, Hester F
dc.contributor.authorIaquaniello, Carolina
dc.contributor.authorStocchetti, Nino
dc.contributor.authorMenon, David
dc.contributor.authorCiterio, Giuseppe
dc.contributor.authorAndelic, Nada
dc.contributor.authorAndreassen, Lasse
dc.contributor.authorAnke, Audny
dc.contributor.authorLund, Stine Borgen
dc.contributor.authorFrisvold, Shirin
dc.contributor.authorHelseth, Eirik
dc.contributor.authorRøe, Cecilie
dc.contributor.authorRøise, Olav
dc.contributor.authorSandrød, Oddrun
dc.contributor.authorSchirmer-Mikalsen, Kari
dc.contributor.authorVik, Anne
dc.contributor.authorÅkerlund, Cecilia
dc.contributor.authorAmrein, Krisztina
dc.contributor.authorAudibert, Gerard
dc.contributor.authorAzouvi, Philippe
dc.contributor.authorAzzolini, Maria Luisa
dc.contributor.authorBartels, Ronald
dc.contributor.authorBeer, Ronny
dc.contributor.authorBellander, Bo-Michael
dc.contributor.authorBenali, Habib
dc.contributor.authorBerardino, Maurizio
dc.contributor.authorBeretta, Luigi
dc.contributor.authorBiqiri, Erta
dc.contributor.authorBlaabjerg, Morten
dc.contributor.authorBrorsson, Camilla
dc.contributor.authorBuki, Andras
dc.contributor.authorCabeleira, Manuel
dc.contributor.authorCaccioppola, Alessio
dc.contributor.authorCalappi, Emiliana
dc.contributor.authorCalvi, Maria Rosa
dc.contributor.authorCameron, Peter
dc.contributor.authorLozano, Guillermo Carbayo
dc.contributor.authorCarbonara, Marco
dc.contributor.authorCastaño-León, Ana M.
dc.contributor.authorChevallard, Giorgio
dc.contributor.authorChieregato, Arturo
dc.contributor.authorCoburn, Mark
dc.contributor.authorColes, Jonathan
dc.contributor.authorCooper, Jamie
dc.contributor.authorCorreia, Marta
dc.contributor.authorCzeiter, Endre
dc.date.accessioned2021-03-22T08:44:46Z
dc.date.available2021-03-22T08:44:46Z
dc.date.created2020-09-06T16:18:08Z
dc.date.issued2020
dc.identifier.citationIntensive Care Medicine. 2020, 46 983-994.en_US
dc.identifier.issn0342-4642
dc.identifier.urihttps://hdl.handle.net/11250/2734673
dc.description.abstractPurpose 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.isoengen_US
dc.publisherSpringeren_US
dc.titleTracheostomy practice and timing in traumatic brain-injured patients: a CENTER-TBI studyen_US
dc.typePeer revieweden_US
dc.typeJournal articleen_US
dc.description.versionpublishedVersionen_US
dc.source.pagenumber983-994en_US
dc.source.volume46en_US
dc.source.journalIntensive Care Medicineen_US
dc.identifier.doi10.1007/s00134-020-05935-5
dc.identifier.cristin1827575
dc.relation.projectNorges forskningsråd: 272789en_US
dc.relation.projectEU/602150en_US
dc.description.localcodeThis article will not be available due to copyright restrictions © 2020 by Springeren_US
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode1


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