We evaluated the association between the timing of tracheostomy and clinical outcomes in patients with infratentorial lesions. We performed a retrospective observational cohort study in a neurosurgical intensive care unit (ICU) at a tertiary academic medical center from January 2014 to December 2018. Consecutive adult patients admitted to the ICU who underwent resection of infratentorial lesions as well as tracheostomy were included for analysis. Early tracheostomy was defined as performed on postoperative days 1–10 and late tracheostomy on days 10–20 after operation. Univariate and multivariate analyses were used to compare the characteristics and outcomes between both cohorts. A total of 143 patients were identified, and 96 patients received early tracheostomy. Multivariable analysis identified early tracheostomy as an independent variable associated with lower occurrence of pneumonia (odds ratio, 0.25; 95% CI, 0.09–0.73; p = 0.011), shorter stays in ICUs (hazard ratio, 0.4; 95% CI, 0.3–0.6; p = 0.03), and earlier decannulation (hazard ratio, 0.5; 95% CI, 0.4–0.8; p = 0.003). However, no significant differences were observed between the early and late tracheostomy groups regarding hospital mortality (p > 0.999) and the modified Rankin scale after 6 months (p = 0.543). We also identified postoperative brainstem deficits, including cough, swallowing attempts, and extended tongue as well as GCS < 8 at ICU admission as the risk factors independently associated with patients underwent tracheostomy. There is a significant association between early tracheostomy and beneficial clinical outcomes or reduced adverse event occurrence in patients with infratentorial lesions.

我们评估了气管下切开术患者气管切开术的时机与临床结局之间的关联。我们于2014年1月至2018年12月在一家三级学术医学中心的神经外科重症监护病房（ICU）进行了一项回顾性观察队列研究。纳入了接受ICU手术的成人成年患者，这些患者接受了根治性切除术和气管切开术。 。早期气管切开术定义为术后1-10天进行，晚期气管切开术在手术后10-20天进行。使用单因素和多因素分析来比较两个队列之间的特征和结果。总共确定了143例患者，其中96例接受了早期气管切开术。p  = 0.011），在ICU停留的时间较短（危险比，0.4； 95％CI，0.3-0.6；p  = 0.03），以及更早的拔管术（危险比，0.5； 95％CI，0.4-0.8；p  = 0.003）。然而，早期和晚期气管切开术组之间在医院死亡率（p  > 0.999）和6个月后改良的Rankin量表（p = 0.543）。我们还确定了术后ICM入院时脑干缺陷，包括咳嗽，吞咽尝试和舌头扩展以及GCS <8，这是与患者进行气管切开术独立相关的危险因素。在气管下病变患者中，早期气管切开术与有益的临床结果或不良事件的发生之间存在显着的关联。