Outcome in tracheostomized patients with severe traumatic brain injury following implementation of a specialized multidisciplinary tracheostomy team

J Head Trauma Rehabil. Sep-Oct 2010;25(5):362-5. doi: 10.1097/HTR.0b013e3181cd67ea.

Abstract

Objective: To evaluate the effect of a specialized multidisciplinary tracheostomy team on outcome of patients with severe traumatic brain injury (sTBI).

Design: Retrospective study with historical controls.

Participants: Twenty-seven patients with sTBI tracheostomized before implementation of the tracheostomy team approach and 34 patients followed by the team.

Setting: A regional level 1 tertiary care trauma center, McGill University Health Centre-Montreal General Hospital.

Main outcome measures: Time to decannulation, length of stay (LOS), Passy-Muir speaking valve use, and extended Glasgow Outcome Scale (GOS-E) scores given at acute care discharge.

Results: The groups were similar for injury severity, age, and premorbid health conditions. Postteam patients had a significantly shorter LOS (P = .025) and more of them used Passy-Muir speaking valves (P = .004). Furthermore, there was a trend toward decreased time to decannulation in the postteam group. GOS-E scores did not differ significantly between groups (P > .05).

Conclusion: Implementation of the tracheostomy team appears to have had positive clinical benefits for this population.

MeSH terms

  • APACHE
  • Adult
  • Brain Injuries / complications
  • Brain Injuries / rehabilitation*
  • Female
  • Glasgow Coma Scale
  • Humans
  • Length of Stay*
  • Male
  • Middle Aged
  • Patient Care Team*
  • Recovery of Function*
  • Retrospective Studies
  • Tracheostomy / rehabilitation*
  • Young Adult