REDUCED USE OF RESOURCES BY EARLY TRACHEOSTOMY IN VENTILATOR-DEPENDENT PATIENTS WITH BLUNT TRAUMA

Background, Early tracheostomy has been advocated for ventilator-depen dent patients with blunt trauma, but its advantages have not been exam ined critically.Methods. We retrospectively reviewed our experience wi th all patients with blunt trauma undergoing tra cheostomy during the 6-year period from 1990 to 1995. Patients undergoing tracheostomy with in the first 6 days of hospitalization were designated as early recipi ents (ET) and those undergoing the procedure at 7 or more days were de fined as late recipients (LT). Results. The entire study group consist ed of 157 patients. The ET group contained 62 patients and the LT grou p contained 95 patients. No statistical differences were noted between the 2 groups with respect to sex distribution, injury severity scores , probability of survival scores, or mortality rates. The mean stay in the intensive care unit for the ET group was 15 days compared with 29 days for the LT group (P less than or equal to .001). The mean total hospital stay for the ET group was 33 days compared with 68 days for t he LT group (P less than or equal to .001). The mean estimated per-pat ient hospital charges for only room and ventilator care were $36,609 f or the ET group compared with $73,714 for the LT group. Conclusions. E T in this patient group resulted in significantly lowered use of resou rces with no adverse effect on outcome.