ArticleCureus2020
Determinants of the Need for Tracheostomy in Neurocritical Patients.
Article in Cureus, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Patient Outcomes following Immediate Tracheostomy and Emergency Decompressive Craniectomy in the Same Setting.International journal of environmental research and public health · 2022Review
- Improving tracheostomy delivery for trauma and surgical critical care patients: timely trach initiative.BMJ open quality · 2022Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGiven the difficulties in predicting the need for prolonged intubation and the timing of tracheostomy, the stroke-related early tracheostomy score (SETscore) was developed, and this tool has demonstrated moderate accuracy in predicting intensive care unit (ICU) length of stay (LoS), ventilation duration, and need for tracheostomy. We aim to assess the usefulness of SETscore in a more heterogeneous population that includes trauma patients to whom this score has not yet been applied. MATERIAL AND
methodsA retrospective consecutive analysis of all neurocritical patients who were admitted to our medical-surgical ICU between 2016 and 2018 and who required endotracheal intubation within 48 h of admission was performed in this study. Clinicodemographic data, as well as tracheostomy timing, imaging results, and SETscore were evaluated.
resultsThe medical records of 732 neurocritical patients were reviewed, but only 493 patients were included, 68 of whom were tracheostomized (TR). These TR patients presented longer LoS and ventilation and antibiotic duration, lower Glasgow Coma Scale (GCS) score at admission, and more respiratory comorbidities. Severity scores, including SETscore, were higher in the TR group. A SETscore of >10 demonstrated 92.6% sensitivity and 79.1% specificity in predicting the need for tracheostomy. The majority of patients were tracheostomized after the seventh day of ICU admission. No significant differences in SETscore as well as in severity scores, age, and gender were observed between the early and late TR groups. However, the need for tracheostomy was significantly associated with lower ICU death rate even after controlling for GCS at admission, gender, age, and duration of invasive mechanical ventilation.
conclusionSETscore can be applied to a heterogeneous population. However, more data and prospective analyses are needed to validate their clinical usefulness on a daily basis. Nevertheless, the present data are expected to contribute to the management of neurocritical patients, particularly in the setting of ICUs managing a broad spectrum of critically ill patients.
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