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Outcome in tracheostomized patients with severe traumatic brain injury following implementation of a specialized
Joanne LeBlanc1, Judith Robillard Shultz, Alena Seresova
1McGill University Health Centre-Montreal General Hospital, Montreal, Quebec, Canada.
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.
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