OBJECTIVE: The value of optimal timing of tracheostomy in @entity1 with @entity510 is controversially debated. This study investigates whether early or late tracheostomy is associated with beneficial outcome or reduced rates of adverse events. DESIGN: Retrospective observational multicentric on @entity1 prospectively inserted into a database. SETTING: Neurologic ICUs of one academic hospital and two secondary hospitals in Germany. @entity1 : Data of all @entity1 admitted to the Goethe University Hospital between 2006 and 2011 with poor-grade @entity510 were prospectively entered into a database. All @entity1 who underwent tracheostomy were included for analysis. Follow-up was maintained in primary and secondary ICUs. INTERVENTIONS: @entity1 underwent tracheostomy upon expected long-term ventilation. Early tracheostomy was defined as -performed on days 1-7 and late tracheostomy on days 8-20 after admission. MEASUREMENT AND MAIN RESULTS: We compared 148 consecutive @entity1 admitted with poor-grade (World Federation of Neurosurgical Societies, 3-5) @entity510 . Early tracheostomy was performed in 39 @entity1 and late tracheostomy in 109 @entity1 . In early versus late tracheostomy groups, no significant differences were observed with regard to ICU mortality (7.7% vs 7.3%; p = 0.93) and median modified Rankin Scale after 6 months (3 vs 3; p = 0.94). Of the early group, @entity55 developed in 19 @entity1 , whereas in the late group, @entity55 developed in 75 @entity1 (48.7% vs 68.8%; p = 0.03; odds ratio, 2.32; 95% CI, 1.1-4.9). Six @entity1 of the early group (15.4%) and 36 @entity1 of the late group (33%) suffered from respiratory adverse event (p = 0.04; odds ratio, 2.71; 95% CI, 1.04-7.06). Mechanical ventilation was shorter (17.4 vs 22.3 d; p < 0.05) and decannulation occurred earlier (42 vs 54 d; p = 0.039) in the early tracheostomy group. CONCLUSIONS: Tracheostomy within 7 days of critical care admission is a feasible and safe procedure for @entity1 with poor-grade @entity510 . Early tracheostomy was not associated with an improvement in mortality or neurologic outcome but associated with fewer respiratory adverse events.

The Impact of Tracheostomy Timing on Clinical Outcome and Adverse Events in Poor-Grade XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PATIENTS'] @entity55 :: ('MESH:D011014', 'Disease') :: ['pneumonia'] @entity510 :: ('MESH:D013345', 'Disease') :: ['subarachnoid hemorrhage']
@entity510 :: (MESH:D013345,Disease) :: ['Subarachnoid Hemorrhage']
