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Rehabilitation of Difficult-to-Wean, Tracheostomized Patients Admitted to Specialized Unit: Retrospective Analyses over 10-Years

Rehabilitation outcomes of difficult-to-wean tracheostomized patients have been reported in relatively small case studies and described for a limited time span. This study describes the characteristics and clinical outcomes of a large cohort of tracheostomized patients admitted to a specialized wean...

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Autores principales: Costi, Stefania, Brogneri, Antonio, Bagni, Chiara, Pennacchi, Giulia, Beneventi, Claudio, Tabbì, Luca, Dell’Orso, Daniela, Fantini, Riccardo, Tonelli, Roberto, Beghi, Gianfranco Maria, Clini, Enrico
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8910258/
https://www.ncbi.nlm.nih.gov/pubmed/35270675
http://dx.doi.org/10.3390/ijerph19052982
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author Costi, Stefania
Brogneri, Antonio
Bagni, Chiara
Pennacchi, Giulia
Beneventi, Claudio
Tabbì, Luca
Dell’Orso, Daniela
Fantini, Riccardo
Tonelli, Roberto
Beghi, Gianfranco Maria
Clini, Enrico
author_facet Costi, Stefania
Brogneri, Antonio
Bagni, Chiara
Pennacchi, Giulia
Beneventi, Claudio
Tabbì, Luca
Dell’Orso, Daniela
Fantini, Riccardo
Tonelli, Roberto
Beghi, Gianfranco Maria
Clini, Enrico
author_sort Costi, Stefania
collection PubMed
description Rehabilitation outcomes of difficult-to-wean tracheostomized patients have been reported in relatively small case studies and described for a limited time span. This study describes the characteristics and clinical outcomes of a large cohort of tracheostomized patients admitted to a specialized weaning unit over 10 years. We retrospectively analyzed data collected from January 2010 to December 2019 on difficult-to-wean tracheostomized patients who underwent comprehensive rehabilitation. Clinical characteristics collected at admission were the level of comorbidity (by the Cumulative Illness Rating Scale—CIRS) and the clinical severity (by the Simplified Acute Physiology Score—SAPS II). The proportions of patients weaned, decannulated, and able to walk; the change in autonomy level according to the Bristol Activities of Daily Living (BADL) Scale; and the setting of hospital discharge was assessed and compared in a consecutive 5-year time period (2010–2014 and 2015–2019) subgroup analysis. A total of 180 patients were included in the analysis. Patient anthropometry and preadmission clinical management in acute care hospitals were similar across years, but the categories of underlying diagnosis changed (p < 0.001) (e.g., chronic obstructive pulmonary disease—COPD—decreased), while the level of comorbidities increased (p = 0.003). The decannulation rate was 45.6%. CIRS and SAPS II at admission were both significant predictors of clinical outcomes. The proportion of patients whose gain in BADL score increased ≥ 2 points decreased over time. This study confirms the importance of rehabilitation in weaning units for the severely disabled subset of tracheostomized patients. Comorbidities and severity at admission are significantly associated with rehabilitation outcomes at discharge.
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spelling pubmed-89102582022-03-11 Rehabilitation of Difficult-to-Wean, Tracheostomized Patients Admitted to Specialized Unit: Retrospective Analyses over 10-Years Costi, Stefania Brogneri, Antonio Bagni, Chiara Pennacchi, Giulia Beneventi, Claudio Tabbì, Luca Dell’Orso, Daniela Fantini, Riccardo Tonelli, Roberto Beghi, Gianfranco Maria Clini, Enrico Int J Environ Res Public Health Article Rehabilitation outcomes of difficult-to-wean tracheostomized patients have been reported in relatively small case studies and described for a limited time span. This study describes the characteristics and clinical outcomes of a large cohort of tracheostomized patients admitted to a specialized weaning unit over 10 years. We retrospectively analyzed data collected from January 2010 to December 2019 on difficult-to-wean tracheostomized patients who underwent comprehensive rehabilitation. Clinical characteristics collected at admission were the level of comorbidity (by the Cumulative Illness Rating Scale—CIRS) and the clinical severity (by the Simplified Acute Physiology Score—SAPS II). The proportions of patients weaned, decannulated, and able to walk; the change in autonomy level according to the Bristol Activities of Daily Living (BADL) Scale; and the setting of hospital discharge was assessed and compared in a consecutive 5-year time period (2010–2014 and 2015–2019) subgroup analysis. A total of 180 patients were included in the analysis. Patient anthropometry and preadmission clinical management in acute care hospitals were similar across years, but the categories of underlying diagnosis changed (p < 0.001) (e.g., chronic obstructive pulmonary disease—COPD—decreased), while the level of comorbidities increased (p = 0.003). The decannulation rate was 45.6%. CIRS and SAPS II at admission were both significant predictors of clinical outcomes. The proportion of patients whose gain in BADL score increased ≥ 2 points decreased over time. This study confirms the importance of rehabilitation in weaning units for the severely disabled subset of tracheostomized patients. Comorbidities and severity at admission are significantly associated with rehabilitation outcomes at discharge. MDPI 2022-03-03 /pmc/articles/PMC8910258/ /pubmed/35270675 http://dx.doi.org/10.3390/ijerph19052982 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Costi, Stefania
Brogneri, Antonio
Bagni, Chiara
Pennacchi, Giulia
Beneventi, Claudio
Tabbì, Luca
Dell’Orso, Daniela
Fantini, Riccardo
Tonelli, Roberto
Beghi, Gianfranco Maria
Clini, Enrico
Rehabilitation of Difficult-to-Wean, Tracheostomized Patients Admitted to Specialized Unit: Retrospective Analyses over 10-Years
title Rehabilitation of Difficult-to-Wean, Tracheostomized Patients Admitted to Specialized Unit: Retrospective Analyses over 10-Years
title_full Rehabilitation of Difficult-to-Wean, Tracheostomized Patients Admitted to Specialized Unit: Retrospective Analyses over 10-Years
title_fullStr Rehabilitation of Difficult-to-Wean, Tracheostomized Patients Admitted to Specialized Unit: Retrospective Analyses over 10-Years
title_full_unstemmed Rehabilitation of Difficult-to-Wean, Tracheostomized Patients Admitted to Specialized Unit: Retrospective Analyses over 10-Years
title_short Rehabilitation of Difficult-to-Wean, Tracheostomized Patients Admitted to Specialized Unit: Retrospective Analyses over 10-Years
title_sort rehabilitation of difficult-to-wean, tracheostomized patients admitted to specialized unit: retrospective analyses over 10-years
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8910258/
https://www.ncbi.nlm.nih.gov/pubmed/35270675
http://dx.doi.org/10.3390/ijerph19052982
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