Neurocritical Care

, Volume 25, Issue 1, pp 94–104 | Cite as

The SETscore to Predict Tracheostomy Need in Cerebrovascular Neurocritical Care Patients

  • Silvia Schönenberger
  • Faisal Al-Suwaidan
  • Meinhard Kieser
  • Lorenz Uhlmann
  • Julian BöselEmail author
Original Article


Background and Purpose

Patients with severe stroke who require mechanical ventilation and neurointensive care unit (NICU) management often require a tracheostomy (TT). The optimal time point for TT remains unclear and a controversy in everyday NICU life. Here, we prospectively evaluated a score for prediction of TT need in NICU patients with cerebrovascular disease.


Seventy-five consecutively ventilated stroke patients were prospectively included in the study and assessed by the stroke-related early tracheostomy score (SETscore) within the first 24 h of admission. Endpoints were TT need, NICU-length of stay (NICU-LOS), and ventilation time (VT). We examined the correlation of these variables with the SETscore using regression analysis and determined a cut-off by receiver operating characteristic (ROC) analysis.


Twenty-six patients had to be tracheostomized. The mean VT was 8.7 ±8 days and the mean NICU-LOS was 11.6 ± 8 days. The SETscore predicted NICU-LOS with a positive predictive value of 0.748 (p < 0.001) and VT with a positive predictive value of 0.799 (p < 0.001). The ROC analysis demonstrated a SETscore value of 8 to be the optimal cut-off to predict prolonged NICU-LOS, VT, and TT need with a sensitivity of 64 % and a specificity of 86 %.


Based on this monocentric study, the SETscore seems to be a valid tool to indicate prolonged NICU-LOS and VT, as well as TT need in cerebrovascular NICU patients. Confirmation of these results in larger cohorts with various settings may help to develop the SETscore as a decisive tool on primary TT early in time to avoid extubation failure.


Ischemic stroke Intracerebral hemorrhage Subarachnoid hemorrhage Tracheostomy Extubation failure 



This study was not funded.

Compliance with Ethical Standards

Conflict of Interest

Dr. Bösel received travel grants and speaker honoraria from Covidien and Sedana. Dr. Schönenberger, Dr. Al-Suwaidan, Dr. Kieser, and Mr. Uhlmann report no conflicts.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Silvia Schönenberger
    • 1
  • Faisal Al-Suwaidan
    • 2
    • 3
  • Meinhard Kieser
    • 4
  • Lorenz Uhlmann
    • 4
  • Julian Bösel
    • 1
    Email author
  1. 1.Department of NeurologyUniversity of HeidelbergHeidelbergGermany
  2. 2.Neurocritical Care Department, National Neuroscience InstituteKing Fahad Medical CityRiyadhSaudi Arabia
  3. 3.King Saud Bin Abdulaziz University for Health SciencesRiyadhSaudi Arabia
  4. 4.Institute of Medical Biometry and InformaticsUniversity of HeidelbergHeidelbergGermany

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