AUTHOR=Wu Haotian , Wang Hongyue , Yang Xue , Jin Lihua , Liu Qian , Zhou Yao , Chen Zihan , Yao Liqing 

TITLE=Multistage investigation of predictive factors for tracheostomy in brain injury: a bibliometric, descriptive, and retrospective analysis

JOURNAL=Frontiers in Neurology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1648046

DOI=10.3389/fneur.2025.1648046

ISSN=1664-2295

ABSTRACT=BackgroundBrain injury, particularly traumatic brain injury (TBI), stands as a prominent global cause of mortality and disability. Tracheostomy in TBI patients may lead to added complications. However, the current literature lacks consistency regarding predictive factors for tracheostomy in this patient population. This study seeks to investigate and validate specific predictive factors associated with the need for tracheostomy in TBI patients through a multi-faceted approach involving bibliometric analysis, descriptive examination, and retrospective research.MethodsThis study employs a multi-stage design: a bibliometric analysis of recent literature on tracheostomy predictors in brain injury patients, followed by a descriptive analysis using PRISMA 2020 guidelines. Clinical data from TBI patients are collected, with univariate and Spearman correlation analyses identifying independent predictive factors.ResultThe bibliometric analysis reveals growing research on tracheostomy prediction in brain injury patients, with key themes including “mortality,” “management,” and “outcomes.” Descriptive analysis of five studies identified common predictors such as low Glasgow Coma Scale (GCS) score, advanced age, multiple injuries, pulmonary complications, and brain imaging features. Retrospective clinical data showed a significant association between diffuse axonal injury (DAI) and tracheostomy need, particularly with injury causes and decompressive craniectomy. Spearman correlations highlighted significant relationships with GCS, illness duration, age, pupil response, Marshall score, and brainstem injury, as well as weak correlations with DAI and injury causes.ConclusionThis study identified predictive factors for tracheostomy in brain-injured patients, focusing on TBI. Key factors include GCS score, DAI presence, age, decompressive craniectomy, and injury severity.