Objective indications for early tracheostomy after blunt head trauma.
BACKGROUND
Early tracheostomy has been shown to be beneficial after trauma; however, there are few objective data to identify early in the recovery period which patients will ultimately require tracheostomy after blunt head trauma.


METHODS
The charts of all patients admitted to the surgical intensive care unit intubated at a level 1 urban trauma center, over a 5-year period with a primary admission diagnosis of blunt head trauma were retrospectively reviewed.


RESULTS
Sixty-four patients met inclusion and exclusion criteria and were divided into two groups: those extubated and those that required tracheostomy. By day 3 the Glasgow Coma Scores for the two groups were significantly different and on day 4 the Simplified Acute Physiology (SAPS) Scores were significantly different.


CONCLUSIONS
Calculating objective scores such as GCS and SAPS can aid in identifying those patients who will ultimately require a tracheostomy for prolonged airway protection after blunt head trauma with high positive predictive value.
Major
Kevin M
KM
Burns and Allen Research Institute, Division of Surgical Critical Care, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Hui
Thomas
T
Wilson
Matthew T
MT
Gaon
Mark D
MD
Shabot
M Michael
MM
Margulies
Daniel R
DR
D018806:APACHE; D000328:Adult; D000368:Aged; D005260:Female; D015600:Glasgow Coma Scale; D016489:Head Injuries, Closed / Q000145:classification / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial; D014139:Tracheostomy