Multistage investigation of predictive factors for tracheostomy in brain injury: a bibliometric, descriptive, and retrospective analysis.

BACKGROUND

Brain injury, particularly traumatic brain injury (TBI), stands as a prominent global cause of mortality and disability. Tracheostomy in TBI patients may lead to added complications. However, the current literature lacks consistency regarding predictive factors for tracheostomy in this patient population. This study seeks to investigate and validate specific predictive factors associated with the need for tracheostomy in TBI patients through a multi-faceted approach involving bibliometric analysis, descriptive examination, and retrospective research.

METHODS

This study employs a multi-stage design: a bibliometric analysis of recent literature on tracheostomy predictors in brain injury patients, followed by a descriptive analysis using PRISMA 2020 guidelines. Clinical data from TBI patients are collected, with univariate and Spearman correlation analyses identifying independent predictive factors.

RESULT: The bibliometric analysis reveals growing research on tracheostomy prediction in brain injury patients, with key themes including "mortality," "management," and "outcomes." Descriptive analysis of five studies identified common predictors such as low Glasgow Coma Scale (GCS) score, advanced age, multiple injuries, pulmonary complications, and brain imaging features. Retrospective clinical data showed a significant association between diffuse axonal injury (DAI) and tracheostomy need, particularly with injury causes and decompressive craniectomy. Spearman correlations highlighted significant relationships with GCS, illness duration, age, pupil response, Marshall score, and brainstem injury, as well as weak correlations with DAI and injury causes.

CONCLUSION

This study identified predictive factors for tracheostomy in brain-injured patients, focusing on TBI. Key factors include GCS score, DAI presence, age, decompressive craniectomy, and injury severity.