Early tracheostomy in patients with cervical spine injury reduces morbidity and improves resource utilization.

BACKGROUND

Aim of our study is to analyze the impact of Early Tracheostomy (ET) in patients with cervical-spine (C-spine) injuries.

METHODS

We analyzed seven-year (2010-2016) ACS-TQIP databank and included all non-TBI trauma patients diagnosed with c-spine injuries. Patients were stratified into two groups based on the timing of tracheostomy (Early; ≤7days: Late; >7days). Outcomes were complications, hospital and ICU stay. Regression analysis was performed.

RESULTS

We included 1139 patients. Mean age was 47 ± 12, median ISS was 18 [12-28], and median C-spine AIS was 4 [3-5]. 24.5% of the patients received ET. On regression analysis, patients who received ET had lower overall-complications (OR:0.57) and ventilator-associated pneumonia (OR:0.61). ET was associated with shorter duration of mechanical ventilation, and hospital and ICU stay. There was no difference in mortality rate.

CONCLUSIONS

Early tracheostomy in patients with C-spine injuries was associated with lower rates of ventilator-associated-pneumonia, shorter duration of mechanical ventilation, and ICU and hospital stay.