The effect of tracheotomy timing on short- term prognosis in hypertensive intracerebral haemorrhage patients after craniectomy: a retrospective analysis of early vs late intervention

Abstract

Objective: The present study aimed to compare the clinical outcomes and short-term prognosis in patients with hypertensive intracerebral haemorrhage (HICH) with basal ganglia haematoma volume ≥ 60 mL who underwent early tracheotomy versus late tracheotomy post-craniectomy. Methods: A retrospective analysis was conducted based on the data of 102 patients with basal ganglia haematoma volume ≥ 60 mL after craniectomy between 2016 and 2021. Patients were divided into two groups: early tracheotomy and late tracheotomy. This study evaluated the effect of early tracheotomy on prognosis within 90 days and the impact of tracheotomy timing on overall survival in patients with HICH. Results: Patients in the early tracheotomy group showed a significant reduction in duration of ventilation and intracranial pressure (ICP) at 24 hours (post-tracheotomy) compared to those in the late tracheotomy group. Multivariable logistic regression indicated that late tracheotomy after craniectomy, old age, Glasgow Coma Scale (GCS) ≤ 6, large haematoma volume, and pneumonia after tracheotomy were risk factors for poor prognosis within 90 days in patients with HICH undergoing tracheotomy postoperatively. In terms of the impact of tracheotomy timing on overall survival in patients with HICH, 46 patients died within a follow-up period of 90 days; 19 in the early tracheotomy group (overall survival rate 62.7%), and 27 in the late tracheotomy group (overall survival of 47.1%). Conclusions: Early tracheotomy significantly improved the short-term prognosis of patients with HICH, with a higher overall survival rate compared to late tracheotomy within 90 days of illness.