Does Tracheostomy Timing After Cervical Fixation Impact Infection Rates?

Author(s):

Jasmine Patel; Jessica Tullington; Chih-Yuan Fu; Laura Brown; Faran Bokhari; James Alford Flippin

Background:

There is a frequent inclination to delay tracheostomy after the implantation of cervical spine hardware due to concern for infection of the hardware.It is well established that early discharge to neurological or spinal rehabilitation correlates to better neurological outcomes.

Hypothesis:

Early tracheostomy after cervical fixation would increase the risk of hardware infection.

Methods:

Using data from ACS TQIP 2016-2020, 415 patients were included who underwent tracheostomy after cervical fixation. These patients were divided into early tracheostomy (<72 hours) and late tracheostomy groups.

Results:

Patients undergoing early tracheostomy received their tracheostomy significantly earlier in their hospital stay (127.2 hrs vs 284.3 hrs, p<.001). ISS and spineAIS were similar between the groups. Time to cervical spine fixation was not significantly different between the groups. Hospital length of stay, ICU length of stay and ventilator days were similar between the groups. Mortality and incidence of surgical site infections were not significantly different between the groups.

Conclusions:

Early tracheostomy after cervical spine fixation does not impart a significantly increased risk of infection.