Short-term Outcome of Early Tracheostomy in the Trauma Patients Admitted to Intensive Care Unit: A Comparative Study

Bijan Ziaeian, Sedigheh Tahmasebi, Hadi Niakan, Afsoun Fazelzadeh
Bulletin of Emergency and Trauma 2013, 1 (3): 112-5

OBJECTIVES: To compare the results of early versus late tracheostomy in trauma patients admitted to intensive care unit (ICU).

METHODS:  This was case control study being performed at a major trauma centre in Shiraz, Iran including 120 trauma patients admitted to ICU during a 2-year period and underwent tracheostomy during their ICU stay. The patients were categorized into two groups of the early tracheostomy who underwent tracheostomy within the first 7 days of initiation of mechanical ventilation (n=60), and the late tracheostomy group, in which tracheostomy was performed after 7 days (n=60). The duration of mechanical ventilation, ICU stay and hospital stay as well as mortality rates in ICU and hospital were recorded and compared between two study groups.

RESULTS: The baseline characteristics such as age (p=0.325), sex (p=0.071), Glasgow coma scale (GCS) (p=0.431) and the mechanism of injury (p=0.822) were comparable between two study groups. Early tracheostomy was associated with a significantly shorter duration  of mechanical ventilation (p=0.008) and shorter ICU stay (p=0.003). Hospital stay (p=0.165), ICU mortality (p=0.243), and hospital mortality (p=0.311) were not different between the two study groups.

CONCLUSION:  Early tracheostomy is associated with reduced ICU stay and shorter duration  of mechanical ventilation. Adopting a standardized strategy may improve resource utilization.


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