Clinical Article
The effect of timing of tracheostomy on clinical outcomes in patients with infratentorial lesions
Huawei Huang, Guobin Zhang, Siwei Tang, Yunsheng Zhang, Changcun Pan, Guangqiang Chen, Jianxin Zhou
Published 2019-06-28
Cite as Chin J Neurosurg, 2019, 35(6): 592-596. DOI: 10.3760/cma.j.issn.1001-2346.2019.06.011
Abstract
ObjectiveTo determine the effect of timing of tracheostomy on clinical outcome in neurosurgical patients with infratentorial lesions admitted to the intensive care unit (ICU).
MethodsA total of 253 neurosurgical patients with infratentorial lesions, who underwent tracheostomy at Department of Intensive Care Unit (ICU), Beijing Tiantan Hospital from January 2015 to December 2017, were enrolled into this study. Patients were divided into 2 groups based on the timing of tracheostomy. Tracheostomy was performed within 7 days after operation in the early group (group E, n=128), whereas in the late group, it was performed after 7 days post operation (group L, n=125). Total duration of mechanical ventilation (MV), length of stay (LOS) at ICU, hospital LOS, and incidence of ventilator-associated pneumonia (VAP) were compared between the 2 groups.
ResultsThe total MV duration, ICU and hospital LOS were significantly longer in group L than in group E [M(P25, P75): 7 (3.0, 12.0) d vs. 0 (0, 5.8) d; 19 (15.0, 25.5) d vs. 9 (8.0, 12.0) d, 31 (27.0, 39.5) d vs. 20 (17.0, 24.0) d, respectively, all P<0.001]. The incidence of VAP was higher in group L than in group E [88.0%(110/125) vs. 30.5%(39/128), P<0.01].
ConclusionEarly (within 7 days) tracheostomy could reduce the MV duration, ICU LOS and incidence of VAP in critically ill neurosurgical patients with infratentorial lesions.
Key words:
Infratentorial neoplasms; Intensive care units; Tracheotomy; Operation time; Prognosis
Contributor Information
Huawei Huang
Department of Intensive Care Unit, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Guobin Zhang
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Siwei Tang
Department of Intensive Care Unit, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Yunsheng Zhang
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Changcun Pan
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Guangqiang Chen
Department of Intensive Care Unit, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Jianxin Zhou
Department of Intensive Care Unit, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
