Predictors of tracheostomy in patients with spontaneous intracerebral hemorrhage

Shadi Yaghi, Page Moore, Bappaditya Ray, Salah G. Keyrouz

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: One third of patients with intracerebral hemorrhage (ICH) require mechanical ventilation; in most, tracheostomy may be necessary. Limited data exist about predictors of tracheostomy in ICH. The aim of our study is to identify predictors of tracheostomy in ICH. Methods: We reviewed medical records of patients seen in our institution between 2005 and 2009, using ICD-9 codes for ICH, for admission clinical and radiological parameters. A stepwise logistic regression model was used to identify tracheostomy predictors. Results: Ninety patients with ICH were included in the analysis, eleven of which required tracheostomy. Patients requiring a tracheostomy were more likely to have a large hematoma volume (≥30 mL) (63.4% vs. 29.1%, p = 0.037), intraventricular hemorrhage (81.8% vs. 27.8%, p < 0.0001), hydrocephalus (81.8% vs. 8.8%, p < 0.0001), admission GCS < 8 (81.8% vs. 5.1%, p < 0.0001), intubation ≥ 14 days (54.5% vs. 1.27%, p < 0.0001) and pneumonia (63.6% vs. 17.7%, p = 0.003). Stepwise logistic regression yielded admission GCS (OR = 80.55, p = 0.0003) and intubation days (OR = 87.49, p < 0.006) as most important predictors. Conclusion: We could potentially predict the need for tracheostomy early in the course of ICH based on the admission GCS score; duration of intubation is another predictor for tracheostomy. Early tracheostomy could decrease the time, and therefore risks of prolonged endotracheal intubation and length of hospital stay.

Original languageEnglish (US)
Pages (from-to)695-698
Number of pages4
JournalClinical Neurology and Neurosurgery
Volume115
Issue number6
DOIs
StatePublished - Jun 1 2013
Externally publishedYes

Fingerprint

Tracheostomy
Cerebral Hemorrhage
Intubation
Logistic Models
International Classification of Diseases
Length of Stay
Intratracheal Intubation
Hydrocephalus
Artificial Respiration
Hematoma
Medical Records
Pneumonia
Hemorrhage

Keywords

  • Endotracheal intubation
  • GCS
  • Hydrocephalus
  • Intracerebral hemorrhage
  • Intraventricular hemorrhage
  • Tracheostomy

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Predictors of tracheostomy in patients with spontaneous intracerebral hemorrhage. / Yaghi, Shadi; Moore, Page; Ray, Bappaditya; Keyrouz, Salah G.

In: Clinical Neurology and Neurosurgery, Vol. 115, No. 6, 01.06.2013, p. 695-698.

Research output: Contribution to journalArticle

Yaghi, Shadi ; Moore, Page ; Ray, Bappaditya ; Keyrouz, Salah G. / Predictors of tracheostomy in patients with spontaneous intracerebral hemorrhage. In: Clinical Neurology and Neurosurgery. 2013 ; Vol. 115, No. 6. pp. 695-698.
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abstract = "Background: One third of patients with intracerebral hemorrhage (ICH) require mechanical ventilation; in most, tracheostomy may be necessary. Limited data exist about predictors of tracheostomy in ICH. The aim of our study is to identify predictors of tracheostomy in ICH. Methods: We reviewed medical records of patients seen in our institution between 2005 and 2009, using ICD-9 codes for ICH, for admission clinical and radiological parameters. A stepwise logistic regression model was used to identify tracheostomy predictors. Results: Ninety patients with ICH were included in the analysis, eleven of which required tracheostomy. Patients requiring a tracheostomy were more likely to have a large hematoma volume (≥30 mL) (63.4{\%} vs. 29.1{\%}, p = 0.037), intraventricular hemorrhage (81.8{\%} vs. 27.8{\%}, p < 0.0001), hydrocephalus (81.8{\%} vs. 8.8{\%}, p < 0.0001), admission GCS < 8 (81.8{\%} vs. 5.1{\%}, p < 0.0001), intubation ≥ 14 days (54.5{\%} vs. 1.27{\%}, p < 0.0001) and pneumonia (63.6{\%} vs. 17.7{\%}, p = 0.003). Stepwise logistic regression yielded admission GCS (OR = 80.55, p = 0.0003) and intubation days (OR = 87.49, p < 0.006) as most important predictors. Conclusion: We could potentially predict the need for tracheostomy early in the course of ICH based on the admission GCS score; duration of intubation is another predictor for tracheostomy. Early tracheostomy could decrease the time, and therefore risks of prolonged endotracheal intubation and length of hospital stay.",
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AB - Background: One third of patients with intracerebral hemorrhage (ICH) require mechanical ventilation; in most, tracheostomy may be necessary. Limited data exist about predictors of tracheostomy in ICH. The aim of our study is to identify predictors of tracheostomy in ICH. Methods: We reviewed medical records of patients seen in our institution between 2005 and 2009, using ICD-9 codes for ICH, for admission clinical and radiological parameters. A stepwise logistic regression model was used to identify tracheostomy predictors. Results: Ninety patients with ICH were included in the analysis, eleven of which required tracheostomy. Patients requiring a tracheostomy were more likely to have a large hematoma volume (≥30 mL) (63.4% vs. 29.1%, p = 0.037), intraventricular hemorrhage (81.8% vs. 27.8%, p < 0.0001), hydrocephalus (81.8% vs. 8.8%, p < 0.0001), admission GCS < 8 (81.8% vs. 5.1%, p < 0.0001), intubation ≥ 14 days (54.5% vs. 1.27%, p < 0.0001) and pneumonia (63.6% vs. 17.7%, p = 0.003). Stepwise logistic regression yielded admission GCS (OR = 80.55, p = 0.0003) and intubation days (OR = 87.49, p < 0.006) as most important predictors. Conclusion: We could potentially predict the need for tracheostomy early in the course of ICH based on the admission GCS score; duration of intubation is another predictor for tracheostomy. Early tracheostomy could decrease the time, and therefore risks of prolonged endotracheal intubation and length of hospital stay.

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