The following is a summary of “Impact of Timing of Tracheostomy Placement among Geriatric Patients with Isolated Severe Traumatic Brain Injury: A Nationwide Analysis,” published in the November 2024 issue of Surgery by Rosario et al.    

The effect of tracheostomy timing on outcomes remains uncertain in geriatric patients with severe traumatic brain injury (TBI).  

Researchers conducted a retrospective study investigating the impact of early vs. late tracheostomy placement on outcomes in geriatric patients with severe TBI.  

They identified patients aged 65 or older with isolated severe TBI who underwent tracheostomy (American College of Surgeons Trauma Quality Improvement Program [ACS-TQIP] 2017-2020 database). Patients were categorized into early (<10 days) and late (≥10 days) tracheostomy groups. Propensity score matching was used to control confounding factors. Outcomes analyzed included mortality, hospital length of stay (H-LOS), intensive care unit length of stay (ICU-LOS), ventilator days, and complications.  

The results showed 1,385 patients, 637 (46.0%) had early tracheostomy. After propensity score matching, early tracheostomy was associated with shorter H-LOS (18 vs. 25 days, P<0.001), ICU-LOS (14 vs. 20 days, P<0.001), and fewer ventilator days (12 vs. 17 days, P<0.001). Additionally, deep vein thrombosis (DVT) occurred less frequently in the early tracheostomy group (6.7% vs. 11.3%, P=0.024), though mortality rates were similar (11.1% vs. 9.5%, P=0.48).  

They concluded that early tracheostomy in geriatric patients with isolated severe TBI was linked to shorter H-LOS, fewer ventilator days, and fewer complications, suggesting the benefits of earlier intervention.  

Source: americanjournalofsurgery.com/article/S0002-9610(24)00652-4/abstract