title: The Impact of Early Tracheostomy in Neurotrauma Patients: A Retrospective Study.
abstract: BACKGROUND
  Although majority of neurotrauma patients require long term ventilatory support but the timing of tracheostomy in such patients is controversial.
  
  
  METHODS
  This retrospective study was conducted at a Tertiary Care Hospital, Pune, India. Patients >18 years of age, who underwent percutaneous tracheostomy (PCT) from June 2010 to November 2014 at neurotrauma unit (NTU) of hospital, were included. Patients were divided in two groups according to the timing of tracheostomy, early tracheostomy (ET) group (≤5 days;N=100) and late tracheostomy (LT) group (>5 days;N=64). The nonparametric Mann-Whitney test, and Chi-square tests were used to compare these groups.
  
  
  RESULTS
  There were no significant differences between the groups in terms of age, sex, APACHE II and GCS Score. Patients in the ET group had a significantly shorter stay in the NTU compared to patients in the LT group (mean, 18 vs. 21.2 days, p=0.005), fewer mechanical ventilation days (mean, 8.1 vs. 11.7 days,P=0.000) and shorter length of stay in hospital (mean, 28.8 vs. 34.37 days,P=0.019). There was no difference between ET and LT groups in post PCT ventilator free days (mean, 8.2 vs. 9.4 days;P=0.094). Mortality rates in ET vs. LT groups were also comparable (35% vs. 29.7%;P=0.480).
  
  
  CONCLUSIONS
  Results suggest that ET in neurotrauma patients might be associated with shorter length of stay in NTU and hospital, and shorter duration of mechanical ventilation however there was no mortality difference.
authors.affiliation: Neurotrauma Unit, Ruby Hall Clinic, Pune, Maharashtra, India.
authors.forename: Kapil G
authors.initials: KG
authors.lastname: Zirpe
authors.affiliation: Neurotrauma Unit, Ruby Hall Clinic, Pune, Maharashtra, India.
authors.forename: Deepali Vishnu
authors.initials: DV
authors.lastname: Tambe
authors.affiliation: Neurotrauma Unit, Ruby Hall Clinic, Pune, Maharashtra, India.
authors.forename: Abhijit M
authors.initials: AM
authors.lastname: Deshmukh
authors.affiliation: Neurotrauma Unit, Ruby Hall Clinic, Pune, Maharashtra, India.
authors.forename: Sushma K
authors.initials: SK
authors.lastname: Gurav
keywords: Early tracheostomy; neurotrauma; traumatic brain injury