The Impact of early tracheostomy toward the functional outcome of severe head injury patients

Mahmud, Muhammad Farhan and Mohamed Ludin, Salizar and Awang, Mohamed Saufi (2025) The Impact of early tracheostomy toward the functional outcome of severe head injury patients. Malaysian Journal of Medicine and Health Sciences, 21 (Supp 6). pp. 38-42. ISSN 1675-8544 E-ISSN 2636-9346

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Abstract

Introduction: Patients with severe head injury (SHI) may require mechanical ventilation support for cerebral protection. However, they are at risk of experiencing a prolonged mechanical ventilation episode which requires them for the initiation of tracheostomy. In addition, this vulnerable group also are at risk of having a poor prognosis and functional outcome due to severely impaired cognitive function. The previous study documented the functional outcome status of SHI patients. However, the impact of early tracheostomy was not properly documented, especially in the Malaysian setting. The objective of this study is to determine the impact of early tracheostomy toward the functional outcome of SHI patients. Methods: A retrospective study was conducted, which included 45 SHI patients with tracheostomy from two hospitals. The GOSE instrument had been utilised in determining the impact of early tracheostomy on their functional outcome. Results: Forty-five participants completed the study and were included in the analysis. The univariate analysis performed for the three months post-discharge showed no significant association between the early tracheostomy and the functional outcome. However, the repeated analysis performed at six months post-discharge shows a significant association between these two variables (p=<0.001). The multivariate analysis demonstrated a consistent significant association between the early tracheostomy and the functional outcomes (p=<0.001). Conclusion: At six months post-discharge, the initiation of early tracheostomy contributes to a better functional outcome among patients with a SHI. The patients with early tracheostomy were 18.9% more likely to recover well than those with a late tracheostomy. This study suggests that early tracheostomy should be initiated among severe head injury patients rather than late, if it is not contraindicated, to increase the chance of the patients having a better functional outcome.

Item Type:	Article (Journal)
Uncontrolled Keywords:	Severe Head Injury, Early Tracheostomy, Functional Outcome, TBI, ICU patients.
Subjects:	R Medicine > RT Nursing > RT48 Nursing assessment R Medicine > RT Nursing > RT48 Nursing assessment > RT48.55 Patient monitoring R Medicine > RT Nursing > RT48 Nursing assessment > RT48.6 Nursing diagnosis R Medicine > RT Nursing > RT82 Nursing As A Profession R Medicine > RT Nursing > RT86.3 Nurse and patient R Medicine > RT Nursing > RT86.4 Nurse and physician or other health professionals
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Nursing Kulliyyah of Nursing > Department of Critical Care Nursing Sultan Ahmad Shah Medical Centre (SASMEC)
Depositing User:	DR Salizar Mohamed Ludin
Date Deposited:	14 Aug 2025 08:22
Last Modified:	14 Aug 2025 08:22
URI:	http://irep.iium.edu.my/id/eprint/122654

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