Decannulation patterns and predictors in acquired brain injury: a retrospective study

Area of Science:

• Neurology
• Rehabilitation Medicine
• Critical Care

Background:

• Tracheostomy is common in acquired brain injury (ABI) patients needing prolonged ventilation.
• Prolonged tracheostomy impacts communication, swallowing, and psychological well-being, necessitating timely decannulation.
• Decannulation is a key rehabilitation goal for improving patient outcomes.

Purpose of the Study:

• To examine the time to tracheostomy decannulation (TAD) in ABI patients.
• To identify clinical and functional predictors influencing TAD in this population.

Main Methods:

• Retrospective review of medical records for ABI patients admitted to Physical Medicine and Rehabilitation (2016-2024).
• Inclusion criteria: age ≥18, tracheostomy at admission, and successful decannulation.
• Analysis of 77 patients (stroke, traumatic brain injury, encephalopathy).

Main Results:

• Median TAD was 52 days overall.
• Stroke patients had longer TAD (76 days) than traumatic brain injury (TBI) patients (49.5 days).
• Younger age, higher Glasgow Coma Scale (GCS) scores, and earlier inpatient admission were associated with shorter TAD.

Conclusions:

• Younger age, higher admission GCS, and earlier inpatient rehabilitation predict faster tracheostomy decannulation in ABI.
• Findings can inform goal setting, patient stratification, and timeline management for tracheostomy decannulation.
• Optimizing rehabilitation pathways may expedite decannulation and improve functional recovery in ABI patients.