Tracheostomy Outcomes on Trauma Patients
Bibliographic record
Abstract
Abstract Objective Tracheostomies are performed in trauma patients for multiple purposes. Approaches to the procedure are usually directed by individual expertise and local preferences. Though generally safe, a tracheostomy can cause serious complications. This study aims to identify complications associated with tracheostomies performed at the level I Trauma Center of the Puerto Rico Medical Center (PRMC) to have an advanced foundation to develop and implement guidelines to improve patient outcomes. Study Design A retrospective cross‐sectional study. Setting Level I Trauma Center of the PRMC. Methods Medical charts of 113 trauma adult patients that underwent tracheostomy at the PRMC from 2018 to 2020 were reviewed. Data collected included patient demographics, surgical approach, initial tracheostomy tube size (ITTS), intubation period, and flexible laryngoscopic findings. Complications occurring during and after tracheostomy were documented. The unadjusted relationship of the independent variables and outcome measures was assessed using χ2 and Fisher's test for categorical variables and the Wilcoxon‐Mann‐Whitney rank‐sum test for continuous ones. Results Abnormal airway findings detected on flexible laryngoscopic examination were reported in 30 patients in the open tracheostomy (OT) group and 43 patients in the percutaneous tracheostomy group (p = 0.007). Peristomal granulation tissue was reported in 10 patients with an ITTS 8, while in only 1 patient with an ITTS 6 (p = 0.026). Conclusion This study showed several key findings in our cohort. The OT surgical approach was associated with fewer long‐term complications when compared to the percutaneous approach. Also, a statistically significant difference in peristomal granulation tissue findings was found between the ITTS, ITTS‐6 and ITTS‐8, the smaller size being associated with fewer abnormal findings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".