The impact of tracheostomy timing on the outcomes of patients with acute traumatic spinal cord injury: A systematic review and meta-analysis.
Publication/Presentation Date
8-1-2025
Abstract
BACKGROUND: Spinal cord injury (SCI) can cause serious respiratory problems. Cervical high-level injuries may result in diaphragm paralysis, necessitating tracheostomy to assist airway protection and facilitate breathing.
METHODS: A comprehensive literature search of PubMed, Google Scholar, and Web of Science was performed for published studies comparing outcomes between early versus late tracheostomy in acute traumatic SCI patients.
RESULTS: The initial search returned 1837 articles, after the final review, 17 studies with a total of 3853 patients were included in the meta-analysis. The mortality rate between early and late tracheostomy was not statistically significant (OR = 0.81, 95 % CI = [0.37, 1.78], P = 0.61). However, early tracheostomy was associated with reduced duration of mechanical ventilation (MD = - 10.58, 95 % CI = [-15.22, -5.95], P < 0.01), hospital length of stay (MD = - 8.50, 95 % CI = [-10.95, -6.05], P < 0.01), and ICU length of stay (MD = - 9.12, 95 % CI = [-12.20, -6.05], P < 0.01). Early tracheostomy was also associated with a lower incidence of pneumonia (OR = 0.68, 95 % CI = [0.51, 0.91], P < 0.01). Patients in the early tracheostomy group also experienced fewer tracheostomy-related complications (OR = 0.50, 95 % CI = [0.33, 0.75], P < 0.01).
CONCLUSION: In patients with acute traumatic SCI, early tracheostomy within seven days of injury, surgery, or intubation is associated with reduced duration of mechanical ventilation, and length of stay in the hospital and ICU. Early tracheostomy is also associated with a lower risk of tracheostomy-related complications.
Volume
255
First Page
108968
Last Page
108968
ISSN
1872-6968
Published In/Presented At
Zameni, N., Khoshnoodi, M., Lucke-Wold, B., Harrop, J. S., & Karamian, A. (2025). The impact of tracheostomy timing on the outcomes of patients with acute traumatic spinal cord injury: A systematic review and meta-analysis. Clinical neurology and neurosurgery, 255, 108968. https://doi.org/10.1016/j.clineuro.2025.108968
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
40398339
Department(s)
Administration and Leadership
Document Type
Article