Predictors for Tracheostomy with External Validation of the Stroke-Related Early Tracheostomy Score (SETscore)

Neurocritical Care
Khalid AlsherbiniAndrei Alexandrov

Abstract

Ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) patients often require endotracheal intubation (EI) and mechanical ventilation (MV). Predicting the need for prolonged EI and timing of tracheostomy (TR) is challenging. While TR is performed for about 10-15% of patients in the general intensive care unit (ICU), the rate in the neurological ICU and for stroke patients ranges between 15 and 35%. Thus, we performed an external validation of the recently published SETscore. This is a retrospective review for all patients with IS, non-traumatic ICH, and SAH who required intubation within 48 h of admission to the neurological ICU. We compared the SETscore between tracheostomized versus successfully extubated patients, and early TR (within 7 days) versus late TR (after 7 days). Out of 511 intubated patients, 140 tracheostomized and 105 extubated were included. The sensitivity for a SETscore > 10 to predict the need for TR was 81% (95% CI 74-87%) with a specificity of 57% (95% CI 48-67%). The score had moderate accuracy in correctly identifying those requiring TR and those successfully extubated: 71% (95% CI 65-76%). The AUC of the score was 0.74 (95% CI 0.68-0.81). Multivariable logistic regressio...Continue Reading

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Citations

Mar 21, 2019·Neurocritical Care·David B Seder
May 24, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Alexander FokinIvan Puente
Jan 5, 2021·Curēus·Isabel TaveiraPaula Castelões
Oct 13, 2021·Journal of Intensive Care Medicine·Christopher M KappChristoph T Hutchinson

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