Comparing outcomes of early and late tracheostomy in severe traumatic brain injury patient

Background: Patients with severe traumatic brain injury were expected to have poor GCS recovery and prolonged intubation. Therefore, early tracheostomy procedure was indicated for all severe traumatic brain injury . In view of growing concern regarding the safety and outcome of early tracheostomy...

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Main Author:	Ismail, Muhammad Ihfaz
Format:	Thesis
Language:	English
Published:	2018
Subjects:	R Medicine RF Otorhinolaryngology
Online Access:	http://eprints.usm.my/56786/1/Dr.Muhammad%20Ihfaz%20Ismail-24%20pages.pdf
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spelling	my-usm-ep.567862023-03-01T02:44:44Z Comparing outcomes of early and late tracheostomy in severe traumatic brain injury patient 2018 Ismail, Muhammad Ihfaz R Medicine RF Otorhinolaryngology Background: Patients with severe traumatic brain injury were expected to have poor GCS recovery and prolonged intubation. Therefore, early tracheostomy procedure was indicated for all severe traumatic brain injury . In view of growing concern regarding the safety and outcome of early tracheostomy on these patients, it was deemed valid and needed to be addressed. Method: This study was conducted to compare the outcomes of early and late tracheostomy in severe traumatic brain injury. This study had recruited only severe TBI patient who were admitted to Neurosurgery High Dependency Unit, Hospital Sultanah Aminah, and among them who had underwent tracheostomy.There were three main outcomes noted; duration on ventilaton, length of NHDU stay and rate of ventilator associated pneumonia Results: Out of 155 patient, 72 (46.5%) were in early tracheostomy group and 83 (53.5%) were in late tracheostomy group. Malay ethnicity contributed 95 (61.3%) participants,composed a majority of the study participants. The mean duration on ventilator use was 2.65(1.57) for ETG and 5.63(2.35) for LTG. While, mean NHDU stay was 4.75(1.98) for ETG and 9.77(2.70) for LTG. Upon independent t-test, early duration of tracheostomy had shown significant outcome in reducing length of NHDU stay, (p<0.004) and had shortened duration on mechanical ventilator (p<0.001). Then, from ETG, 69(95.8%) participants had no VAP, and 3(4.2%) had VAP, while for LTG 67(80.7%) had no VAP and 16(19.3%) had VAP. Upon Pearson chi-square test, an association was found between the early tracheostomy in reducing the rate of VAP (p= 0.004). Conclusion: In this study it was found that early tracheostomy was significant in shortening the duration on ventilator, reducing the length of NHDU stay and reducing the rate of ventilator associated pneumonia. 2018 Thesis http://eprints.usm.my/56786/ http://eprints.usm.my/56786/1/Dr.Muhammad%20Ihfaz%20Ismail-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	R Medicine RF Otorhinolaryngology
spellingShingle	R Medicine RF Otorhinolaryngology Ismail, Muhammad Ihfaz Comparing outcomes of early and late tracheostomy in severe traumatic brain injury patient
description	Background: Patients with severe traumatic brain injury were expected to have poor GCS recovery and prolonged intubation. Therefore, early tracheostomy procedure was indicated for all severe traumatic brain injury . In view of growing concern regarding the safety and outcome of early tracheostomy on these patients, it was deemed valid and needed to be addressed. Method: This study was conducted to compare the outcomes of early and late tracheostomy in severe traumatic brain injury. This study had recruited only severe TBI patient who were admitted to Neurosurgery High Dependency Unit, Hospital Sultanah Aminah, and among them who had underwent tracheostomy.There were three main outcomes noted; duration on ventilaton, length of NHDU stay and rate of ventilator associated pneumonia Results: Out of 155 patient, 72 (46.5%) were in early tracheostomy group and 83 (53.5%) were in late tracheostomy group. Malay ethnicity contributed 95 (61.3%) participants,composed a majority of the study participants. The mean duration on ventilator use was 2.65(1.57) for ETG and 5.63(2.35) for LTG. While, mean NHDU stay was 4.75(1.98) for ETG and 9.77(2.70) for LTG. Upon independent t-test, early duration of tracheostomy had shown significant outcome in reducing length of NHDU stay, (p<0.004) and had shortened duration on mechanical ventilator (p<0.001). Then, from ETG, 69(95.8%) participants had no VAP, and 3(4.2%) had VAP, while for LTG 67(80.7%) had no VAP and 16(19.3%) had VAP. Upon Pearson chi-square test, an association was found between the early tracheostomy in reducing the rate of VAP (p= 0.004). Conclusion: In this study it was found that early tracheostomy was significant in shortening the duration on ventilator, reducing the length of NHDU stay and reducing the rate of ventilator associated pneumonia.
format	Thesis
qualification_level	Master's degree
author	Ismail, Muhammad Ihfaz
author_facet	Ismail, Muhammad Ihfaz
author_sort	Ismail, Muhammad Ihfaz
title	Comparing outcomes of early and late tracheostomy in severe traumatic brain injury patient
title_short	Comparing outcomes of early and late tracheostomy in severe traumatic brain injury patient
title_full	Comparing outcomes of early and late tracheostomy in severe traumatic brain injury patient
title_fullStr	Comparing outcomes of early and late tracheostomy in severe traumatic brain injury patient
title_full_unstemmed	Comparing outcomes of early and late tracheostomy in severe traumatic brain injury patient
title_sort	comparing outcomes of early and late tracheostomy in severe traumatic brain injury patient
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2018
url	http://eprints.usm.my/56786/1/Dr.Muhammad%20Ihfaz%20Ismail-24%20pages.pdf
_version_	1776101173374222336

Comparing outcomes of early and late tracheostomy in severe traumatic brain injury patient

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