Impact of Early Tracheostomy on Hospital-Acquired Pneumonia and Infection of Anterior Cervical Fusion Site in Patients with Acute Cervical Cord Injury / 대한신경손상학회지

ABSTRACT

OBJECTIVE: We tried to investigate impact of early tracheostomy on hospital-acquired pneumonia and infection of anterior cervical fusion site in patients with acute cervical cord injury undergoing respiratory difficulty. METHODS: A retrospective analysis was done with 42 subjects received tracheostomy of patients with acute cervical cord injury admitted in our institution from Jan. 2001 to Dec. 2010. The subjects were classified into early tracheostomy group (7 days). We analyzed the incidence of post-tracheostomy pneumonia, intensive care unit (ICU) stay, hospital stay, in-hospital mortality and tracheostomy or anterior cervical fusion site infections. RESULTS: Early tracheostomy was performed in 13 patients (31.0%) and delayed in 29 (69.0%). The incidence of post-tracheostomy pneumonia was significantly lower in the early tracheostomy group than in the delayed (p=0.018). ICU stay was also significantly lower in the early tracheostomy group than in the delayed (p=0.013). Hospital stay was lower in the early tracheostomy group than in the delayed (p=0.061), but was not statistically significant. In-hospital mortality was not different between two groups. There were no patients with infection of anterior cervical fusion site as a consequence of tracheostomy in both groups. CONCLUSION: This study suggests that early tracheostomy may have beneficial effects in patients with acute cervical cord injury. Tracheostomy was not found to increase the risk of infection in previous anterior cervical surgery.