Lanza D C, Koltai P J, Parnes S M, Decker J W, Wing P, Fortune J B
Division of Otolaryngology, Albany Medical Center Hospital, NY 12208.
Ann Otol Rhinol Laryngol. 1990 Jan;99(1):38-41. doi: 10.1177/000348949009900106.
Patients with severe head trauma often require prolonged intubation and subsequent tracheotomy. The Glasgow Coma Scale (GCS), an indicator of the severity of head injury, may help identify that subpopulation of trauma victims who will ultimately undergo tracheotomy. This retrospective study demonstrates through discriminant analysis that the likelihood of tracheotomy is significantly greater in patients with a GCS rating less than or equal to 7 than it is in patients with a GCS rating greater than 7 (p = .0001). Conversely, the presence of thoracoabdominal or maxillofacial injury is associated with but not predictive of eventual tracheotomy. In the hope of minimizing complications and enhancing the utilization of hospital resources, this study argues for early tracheotomy in patients with a GCS score less than or equal to 7 who do not undergo craniotomy and are otherwise stable.
重度颅脑外伤患者常常需要长时间插管及随后的气管切开术。格拉斯哥昏迷量表（GCS）作为颅脑损伤严重程度的指标，可能有助于识别最终需要接受气管切开术的那部分创伤患者。这项回顾性研究通过判别分析表明，格拉斯哥昏迷量表评分为小于或等于7分的患者接受气管切开术的可能性显著高于评分为大于7分的患者（p = 0.0001）。相反，胸腹或颌面损伤与最终气管切开术有关，但不能预测。为了尽量减少并发症并提高医院资源利用率，本研究主张对格拉斯哥昏迷量表评分为小于或等于7分、未接受开颅手术且情况稳定的患者尽早进行气管切开术。
