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Comparison of clinical outcomes of tracheotomy in patients with acute cervical spinal cord injury at different timing.
Wang, Xiao-Ran; Zhang, Qiang; Ding, Wen-Sen; Zhang, Wei; Zhou, Min; Wang, Hai-Bo.
Afiliação
  • Wang XR; Department of Intensive Care Unit, Affiliated Haian Hospital of Nantong University, Nantong 226001, China.
  • Zhang Q; Department of Intensive Care Unit, Affiliated Haian Hospital of Nantong University, Nantong 226001, China.
  • Ding WS; Department of Intensive Care Unit, Affiliated Haian Hospital of Nantong University, Nantong 226001, China.
  • Zhang W; Department of Intensive Care Unit, Affiliated Haian Hospital of Nantong University, Nantong 226001, China.
  • Zhou M; Department of Intensive Care Unit, Affiliated Haian Hospital of Nantong University, Nantong 226001, China.
  • Wang HB; Department of Intensive Care Unit, Affiliated Haian Hospital of Nantong University, Nantong 226001, China. Electronic address: diluchitu14@163.com.
Clin Neurol Neurosurg ; 210: 106947, 2021 11.
Article em En | MEDLINE | ID: mdl-34583275
Respiratory failure is the leading cause of early death after acute CSCI. Tracheotomy is an effective approach to reduce mortality and improve the clinical outcomes. However, the optimal timing for tracheotomy remains controversial. Hence, the study aimed to compare the clinical outcomes of tracheotomy in patients with acute cervical spinal cord injury (CSCI) at different timing. A retrospectively review was performed of acute CSCI patients who underwent tracheotomy in the intensive care unit of Haian Hospital between January 2014 and June 2019. 124 CSCI patients were included and stratified into three groups based on the timing of tracheotomy: early group (≤4 days from initial intubation), medium group (4-10 days from initial intubation), and late group (≥10 days from initial intubation). The clinical outcomes and functional outcomes were analyzed. No significant intergroup differences in baseline characteristics were observed. The late group needed significantly longer duration of mechanical ventilation, longer ICU stay, and suffered higher ICU mortality, higher pneumonia after tracheotomy than the early and medium groups. More patients in the early and medium groups successfully weaned from mechanical ventilation. The early and medium groups achieved better improvement of JOA and NDI scores than the late group at one year after surgery and at the final follow-up. Early to medium term tracheotomy may lead to better clinical and functional outcomes in patients with acute CSCI who require prolonged mechanical ventilation.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuficiência Respiratória / Traumatismos da Medula Espinal / Traqueotomia Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Neurol Neurosurg Ano de publicação: 2021 Tipo de documento: Article País de afiliação: China

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuficiência Respiratória / Traumatismos da Medula Espinal / Traqueotomia Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Neurol Neurosurg Ano de publicação: 2021 Tipo de documento: Article País de afiliação: China