Objective indications for early tracheostomy after blunt head trauma

Am J Surg. 2003 Dec;186(6):615-9; discussion 619. doi: 10.1016/j.amjsurg.2003.08.012.

Abstract

Background: Early tracheostomy has been shown to be beneficial after trauma; however, there are few objective data to identify early in the recovery period which patients will ultimately require tracheostomy after blunt head trauma.

Methods: The charts of all patients admitted to the surgical intensive care unit intubated at a level 1 urban trauma center, over a 5-year period with a primary admission diagnosis of blunt head trauma were retrospectively reviewed.

Results: Sixty-four patients met inclusion and exclusion criteria and were divided into two groups: those extubated and those that required tracheostomy. By day 3 the Glasgow Coma Scores for the two groups were significantly different and on day 4 the Simplified Acute Physiology (SAPS) Scores were significantly different.

Conclusions: Calculating objective scores such as GCS and SAPS can aid in identifying those patients who will ultimately require a tracheostomy for prolonged airway protection after blunt head trauma with high positive predictive value.

MeSH terms

  • APACHE
  • Adult
  • Aged
  • Female
  • Glasgow Coma Scale
  • Head Injuries, Closed / classification
  • Head Injuries, Closed / therapy*
  • Humans
  • Intensive Care Units
  • Intubation, Intratracheal
  • Length of Stay
  • Male
  • Middle Aged
  • Respiration, Artificial
  • Tracheostomy*