Risk Analysis Based on the Timing of Tracheostomy Procedures in Patients with Spinal Cord Injury Requiring Cervical Spine Surgery.

Autor: Galeiras R; Critical Care Unit, Complexo Hospitalario Universitario de A Coruña, Sergas, Instituto de Investigación, Biomédica de A Coruña, Universidade da Coruña, A Coruña, Spain., Mourelo M; Critical Care Unit, Complexo Hospitalario Universitario de A Coruña, Sergas, Instituto de Investigación, Biomédica de A Coruña, Universidade da Coruña, A Coruña, Spain. Electronic address: monica.mourelo.farina@sergas.es., Bouza MT; Critical Care Unit, Complexo Hospitalario Universitario de A Coruña, Sergas, Instituto de Investigación, Biomédica de A Coruña, Universidade da Coruña, A Coruña, Spain., Seoane MT; Clinical Epidemiology and Biostatistics Unit, Complexo Hospitalario Universitario de A Coruña, Sergas, Instituto de Investigación, Biomédica de A Coruña, Universidade da Coruña, A Coruña, Spain., Ferreiro ME; Spinal Cord Injury Unit, Complexo Hospitalario Universitario de A Coruña, Sergas, Instituto de Investigación, Biomédica de A Coruña, Universidade da Coruña, A Coruña, Spain., Montoto A; Spinal Cord Injury Unit, Complexo Hospitalario Universitario de A Coruña, Sergas, Instituto de Investigación, Biomédica de A Coruña, Universidade da Coruña, A Coruña, Spain., Salvador S; Spinal Cord Injury Unit, Complexo Hospitalario Universitario de A Coruña, Sergas, Instituto de Investigación, Biomédica de A Coruña, Universidade da Coruña, A Coruña, Spain., Seoane L; Critical Care Unit, Complexo Hospitalario Universitario de A Coruña, Sergas, Instituto de Investigación, Biomédica de A Coruña, Universidade da Coruña, A Coruña, Spain., Freire D; Critical Care Unit, Complexo Hospitalario Universitario de A Coruña, Sergas, Instituto de Investigación, Biomédica de A Coruña, Universidade da Coruña, A Coruña, Spain.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2018 Aug; Vol. 116, pp. e655-e661. Date of Electronic Publication: 2018 May 19.
DOI: 10.1016/j.wneu.2018.05.065
Abstrakt: Objective: To determine the optimal moment to perform tracheostomy in a patient requiring anterior cervical fixation.
Methods: A retrospective observational study conducted over an 18-year period included 56 patients who had been admitted to the intensive care unit with acute spinal cord injury and underwent tracheostomy and surgical fixation. The sample was divided into 2 groups: at-risk group (31 patients who had undergone tracheostomy before cervical surgery or <4 days after surgery) and not-at-risk group (25 patients who had undergone tracheostomy >4 days after fixation surgery). Descriptive and comparative studies were carried out. Overall trend of the collected data was analyzed using cubic splines (graphic methods).
Results: The only infectious complications diagnosed as related to the surgical procedure were infection of the surgical wound in 2 patients in the not-at-risk group (12%) and deep tissue infection in 1 patient in the at-risk group (3.2%). During the study period, we identified a tendency toward performance of early tracheostomies.
Conclusions: Our results suggest that the presence of a tracheostomy stoma before or immediately after surgery is associated with a low risk of infection of the cervical surgical wound in instrumented spinal fusion.
(Copyright © 2018 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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