TY - JOUR
T1 - Factors associated with tracheostomy decannulation in patients with severe traumatic brain injury
AU - Jenkins, Ryne
AU - Badjatia, Neeraj
AU - Haac, Bryce
AU - Van Besien, Richard
AU - Biedlingmaier, John F.
AU - Stein, Deborah M.
AU - Chang, Wan Tsu
AU - Schwartzbauer, Gary
AU - Parikh, Gunjan
AU - Morris, Nicholas A.
N1 - Publisher Copyright:
© 2020, © 2020 Taylor & Francis Group, LLC.
PY - 2020
Y1 - 2020
N2 - Objective: To assess variables associated with decannulation in patients with traumatic brain injury (TBI). Participants: 79 patients with TBI requiring tracheostomy and ICU admission from January 1st to December 31st, 2014. Design: Retrospective analysis. Measures: Patients decannulated prior to 90 days were compared with patients who remained cannulated. Two Cox Proportional Hazards models were used to predict decannulation using variables prior to tracheostomy and throughout hospitalization. Results: Median time to decannulation was 37 days (Interquartile Range [IQR] 29–67). Variables prior to tracheostomy associated with decannulation included diabetes (HR, 0.15; 95% CI, 0.03–0.84; p =.03), craniotomy (HR, 0.25; 95% CI, 0.06–1.02; p =.05) and acute kidney injury (AKI) (HR, 0.06; 95% CI, 0.01–0.48; p =.01). Variables present throughout hospitalization included age (HR, 1.12; 95% CI, 1.01–1.21; p =.03), ventilator days (HR, 0.74; 95% CI, 0.57–0.95; p =.02), reintubation (HR, 0.07; 95% CI, 0.01–0.64; p =.02), aspiration (HR, 0.01; 95% CI, 0.0–0.29, p =.01), craniotomy (HR, 0.004; 95% CI, 0.0–0.39; p =.02) and AKI (HR, 0.0; 95% CI, 0.0–0.21; p =.01). Conclusion: The presence of diabetes, craniotomy and acute kidney injury may inform the conversation surrounding chances for decannulation prior to tracheostomy.
AB - Objective: To assess variables associated with decannulation in patients with traumatic brain injury (TBI). Participants: 79 patients with TBI requiring tracheostomy and ICU admission from January 1st to December 31st, 2014. Design: Retrospective analysis. Measures: Patients decannulated prior to 90 days were compared with patients who remained cannulated. Two Cox Proportional Hazards models were used to predict decannulation using variables prior to tracheostomy and throughout hospitalization. Results: Median time to decannulation was 37 days (Interquartile Range [IQR] 29–67). Variables prior to tracheostomy associated with decannulation included diabetes (HR, 0.15; 95% CI, 0.03–0.84; p =.03), craniotomy (HR, 0.25; 95% CI, 0.06–1.02; p =.05) and acute kidney injury (AKI) (HR, 0.06; 95% CI, 0.01–0.48; p =.01). Variables present throughout hospitalization included age (HR, 1.12; 95% CI, 1.01–1.21; p =.03), ventilator days (HR, 0.74; 95% CI, 0.57–0.95; p =.02), reintubation (HR, 0.07; 95% CI, 0.01–0.64; p =.02), aspiration (HR, 0.01; 95% CI, 0.0–0.29, p =.01), craniotomy (HR, 0.004; 95% CI, 0.0–0.39; p =.02) and AKI (HR, 0.0; 95% CI, 0.0–0.21; p =.01). Conclusion: The presence of diabetes, craniotomy and acute kidney injury may inform the conversation surrounding chances for decannulation prior to tracheostomy.
KW - Tracheostomy
KW - decannulation
KW - head Injury
KW - traumatic Brain Injury
UR - http://www.scopus.com/inward/record.url?scp=85087789487&partnerID=8YFLogxK
U2 - 10.1080/02699052.2020.1786601
DO - 10.1080/02699052.2020.1786601
M3 - Article
C2 - 32615825
AN - SCOPUS:85087789487
SN - 0269-9052
SP - 1106
EP - 1111
JO - Brain Injury
JF - Brain Injury
ER -