Outcome in tracheostomized patients with severe traumatic brain injury following implementation of a specialized multidisciplinary tracheostomy team

LeBlanc J; Shultz JR; Seresova A; de Guise E; Lamoureux J; Fong N; Marcoux J; Maleki M; Khwaja K
J Head Trauma Rehabil; 25(5): 362-5, 2010 Sep-Oct.
ABSTRACT
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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