LAUSR

OBJECTIVE To identify the impact of some clinical characteristics of sABI patients on the decannulation success during the Intensive Rehabilitation Unit (IRU) stay. DESIGN Nonconcurrent cohort study SETTING: and Participants: Patients with sABI and tracheostomy were retrospectively selected from the database of the IRU of the Don Gnocchi Foundation Institute. MAIN OUTCOME MEASURES Potential predictors of decannulation were screened from variables collected at admission during clinical examination, conducted by trained and experienced examiners. The association between clinical characteristics and decannulation status was investigated through a Cox regression model, and Kaplan-Meier curves were then created for time-event analysis. RESULTS Among 351 patients (mean age 64.1±15.5 years) 54.1% were decannulated during the IRU stay. Absence of pulmonary infections (p <0.001), sepsis (p = 0.001), tracheal alteration at the Fibrobronoscopy examination (p = 0.004) and a higher Coma Recovery Scale-Revised (CRS-R) score(p<0.001) or a better state of consciousness at admission (p=0.001) were associated with a higher probability of decannulation. CONCLUSIONS Fibrobronoscopy assessment of patency of airways and accurate evaluation of the state of consciousness using the CRS-R are relevant in this setting of care to better identify patients who are more likely to have the tracheostomy tube removed. These results may help clinicians choose the appropriate timing and intensity of rehabilitation interventions and plan for discharge.