Respiratory failure is the leading cause of early death after acute CSCI. Tracheotomy is an effective approach to reduce mortality and improve the clinical outcomes. However, the optimal timing for tracheotomy remains controversial. Hence, the study aimed to compare the clinical outcomes of tracheotomy in patients with acute cervical spinal cord injury (CSCI) at different timing. A retrospectively review was performed of acute CSCI patients who underwent tracheotomy in the intensive care unit of Haian Hospital between January 2014 and June 2019. 124 CSCI patients were included and stratified into three groups based on the timing of tracheotomy: early group (≤4 days from initial intubation), medium group (4–10 days from initial intubation), and late group (≥10 days from initial intubation). The clinical outcomes and functional outcomes were analyzed. No significant intergroup differences in baseline characteristics were observed. The late group needed significantly longer duration of mechanical ventilation, longer ICU stay, and suffered higher ICU mortality, higher pneumonia after tracheotomy than the early and medium groups. More patients in the early and medium groups successfully weaned from mechanical ventilation. The early and medium groups achieved better improvement of JOA and NDI scores than the late group at one year after surgery and at the final follow-up. Early to medium term tracheotomy may lead to better clinical and functional outcomes in patients with acute CSCI who require prolonged mechanical ventilation.

呼吸衰竭是急性 CSCI 后早期死亡的主要原因。气管切开术是降低死亡率和改善临床结果的有效方法。然而，气管切开的最佳时机仍存在争议。因此，本研究旨在比较不同时间段急性颈脊髓损伤（CSCI）患者气管切开术的临床结果。对2014年1月至2019年6月在海安医院重症监护室接受气管切开术的急性CSCI患者进行回顾性分析。纳入124例CSCI患者，根据气管切开时间分为三组：早期组（≤4天）从初始插管开始）、中期组（从初始插管开始 4-10 天）和晚期组（从初始插管开始≥10 天）。分析临床结果和功能结果。未观察到基线特征的显着组间差异。与早期和中期组相比，晚期组需要显着延长机械通气时间，延长ICU停留时间，ICU死亡率更高，气管切开后肺炎更高。早期和中期组中有更多患者成功脱离机械通气。早期组和中期组在术后 1 年和末次随访时的 JOA 和 NDI 评分均优于晚期组。对于需要长时间机械通气的急性 CSCI 患者，早期至中期气管切开术可能会带来更好的临床和功能结果。与早期和中期组相比，晚期组需要显着延长机械通气时间，延长ICU停留时间，ICU死亡率更高，气管切开后肺炎更高。早期和中期组中有更多患者成功脱离机械通气。早期组和中期组在术后 1 年和末次随访时的 JOA 和 NDI 评分均优于晚期组。对于需要长时间机械通气的急性 CSCI 患者，早期至中期气管切开术可能会带来更好的临床和功能结果。与早期和中期组相比，晚期组需要显着延长机械通气时间，延长ICU停留时间，ICU死亡率更高，气管切开后肺炎更高。早期和中期组中有更多患者成功脱离机械通气。早期组和中期组在术后 1 年和末次随访时的 JOA 和 NDI 评分均优于晚期组。对于需要长时间机械通气的急性 CSCI 患者，早期至中期气管切开术可能会带来更好的临床和功能结果。早期和中期组中有更多患者成功脱离机械通气。早期组和中期组在术后 1 年和末次随访时的 JOA 和 NDI 评分均优于晚期组。对于需要长时间机械通气的急性 CSCI 患者，早期至中期气管切开术可能会带来更好的临床和功能结果。早期和中期组中有更多患者成功脱离机械通气。早期组和中期组在术后 1 年和末次随访时的 JOA 和 NDI 评分均优于晚期组。对于需要长时间机械通气的急性 CSCI 患者，早期至中期气管切开术可能会带来更好的临床和功能结果。