• Belinda H McCully, Loic Fabricant, Travis Geraci, Alissa Greenbaum, Martin A Schreiber, and Stephanie D Gordy.
• Trauma Research Institute of Oregon, Division of Trauma, Critical Care and Acute Care Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA. Electronic address: houghtob@ohsu.edu.
• Am. J. Surg. 2014 May 1;207(5):664-8; discussion 668-9.

BackgroundFailed extubation and delayed tracheostomy contribute to poor outcomes in patients with a traumatic spinal cord injury (SCI). We determined if the level and completeness of SCI predict the need for tracheostomy.MethodsData from 256 patients with SCI between C1 and T3 with or without tracheostomy were retrospectively analyzed. Logistic regression identified predictors for tracheostomy. Data are presented as raw percentage or odds ratio (OR) with 95% confidence interval. P < .05 indicates significance.ResultsComplete spinal cord injuries were common in patients requiring tracheostomy (55% vs 18%, P < .05), and predicted the need for tracheostomy (OR: 6.4 (3.1 to 13.5), P < .05). An injury above C6 predicted the need for tracheostomy in patients with complete injury (OR: 3.7 (1 to 11.9), P < .05), but not incomplete injury (OR: .7 (.3 to 1.9); P = .53).ConclusionTracheostomy is unlikely in patients with incomplete SCI, regardless of the level of injury. Patients with complete SCI above C6 are likely to require tracheostomy.Copyright © 2014 Elsevier Inc. All rights reserved.

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