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

Stefania Costi, Antonio Brogneri, Chiara Bagni, Giulia Pennacchi, Claudio Beneventi, Luca Tabbì, Daniela Dell’Orso, Riccardo Fantini, Roberto Tonelli, Gianfranco Maria Beghi and Enrico Clini
Additional contact information
Stefania Costi: Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine CHIMOMO, University of Modena and Reggio Emilia, 41121 Modena, Italy
Antonio Brogneri: Respiratory Rehabilitation of Ospedale Villa Pineta-KOS Group, 41026 Pavullo nel Frignano (MO), Italy
Chiara Bagni: School of Physiotherapy, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine CHIMOMO, University of Modena and Reggio Emilia, 41121 Modena, Italy
Giulia Pennacchi: School of Physiotherapy, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine CHIMOMO, University of Modena and Reggio Emilia, 41121 Modena, Italy
Claudio Beneventi: Respiratory Rehabilitation of Ospedale Villa Pineta-KOS Group, 41026 Pavullo nel Frignano (MO), Italy
Luca Tabbì: Respiratory Diseases Unit, Department of Medical and Surgical Sciences SMECHIMAI, University Hospital of Modena, University of Modena and Reggio Emilia, 41121 Modena, Italy
Daniela Dell’Orso: Respiratory Rehabilitation of Ospedale Villa Pineta-KOS Group, 41026 Pavullo nel Frignano (MO), Italy
Riccardo Fantini: Respiratory Diseases Unit, Department of Medical and Surgical Sciences SMECHIMAI, University Hospital of Modena, University of Modena and Reggio Emilia, 41121 Modena, Italy
Roberto Tonelli: Respiratory Diseases Unit, Department of Medical and Surgical Sciences SMECHIMAI, University Hospital of Modena, University of Modena and Reggio Emilia, 41121 Modena, Italy
Gianfranco Maria Beghi: Respiratory Rehabilitation of Ospedale Villa Pineta-KOS Group, 41026 Pavullo nel Frignano (MO), Italy
Enrico Clini: Respiratory Diseases Unit, Department of Medical and Surgical Sciences SMECHIMAI, University Hospital of Modena, University of Modena and Reggio Emilia, 41121 Modena, Italy

IJERPH, 2022, vol. 19, issue 5, 1-11

Abstract: 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.

Keywords: tracheostomy; difficult weaning; rehabilitation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/19/5/2982/pdf (application/pdf)
https://www.mdpi.com/1660-4601/19/5/2982/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:19:y:2022:i:5:p:2982-:d:763728

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().