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Factors Associated With Tracheostomy in Ventilated Pediatric Trauma Patients. A National Trauma Database Study

Nasim Ahmed1,2, Yen-Hong Kuo2,3

  • 1Division of Trauma and Surgical Critical Care, Jersey Shore University Medical Center, Neptune NJ USA.

The American Surgeon
|December 6, 2023
PubMed

Insights

Factors associated with tracheostomy in pediatric trauma patients include lower Glasgow Coma Scale scores and severe spine injuries. Higher-level trauma centers also showed a higher proportion of these procedures.

Area of Science:

  • Pediatric Trauma Surgery
  • Critical Care Medicine

Background:

  • Tracheostomy is a critical intervention for prolonged mechanical ventilation in pediatric trauma patients.
  • Identifying factors influencing tracheostomy decisions is essential for optimizing patient care and resource allocation.

Purpose of the Study:

  • To identify factors associated with tracheostomy procedures in pediatric trauma patients requiring mechanical ventilation.
  • To analyze the impact of injury severity and trauma center designation on tracheostomy rates.

Main Methods:

  • Utilized the Trauma Quality Improvement Program (TQIP) database (2017-2019).
  • Included pediatric patients (<18 years) on mechanical ventilation >96 hours.
  • Performed multiple logistic regression analysis to determine associated factors.

Main Results:

  • 71.88% of 2653 patients underwent tracheostomy.
  • Lower Glasgow Coma Scale (GCS) scores and severe spine injury (AIS ≥3) were significantly associated with tracheostomy (P < .05).
  • Level I pediatric trauma centers performed tracheostomies more frequently (OR: 1.848, P < .001).

Conclusions:

  • Lower GCS scores and severe spine injuries are key indicators for tracheostomy in pediatric trauma.
  • Higher-level trauma centers are associated with increased tracheostomy rates in this population.
Abstract

Keywords:
mechanical ventilationsevere traumatracheostomy

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