| Titre : | Decannulation After a Severe Acquired Brain Injury (2020) |
| Auteurs : | Bahia Hakiki ; Francesca Draghi ; Silvia Pancani ; Emilio Portaccio ; Antonello Grippo ; Barbara Binazzi ; Ariela Tofani ; Maenia Scarpino ; Claudio Macchi ; Francesca Cecchi |
| Type de document : | Article |
| Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 101, n° 11, 2020) |
| Article en page(s) : | p. 1906-1913 |
| Note générale : | https://doi.org/10.1016/j.apmr.2020.05.004 |
| Langues: | Anglais |
| Descripteurs : |
HE Vinci Bronchoscopie ; Lésions encéphaliques ; Réadaptation ; Trachéostomie ; Troubles de la conscience |
| Résumé : |
Objective
To identify the effect of some clinical characteristics of severe acquired brain injury (sABI) patients on decannulation success during their intensive rehabilitation unit (IRU) stay. Design Nonconcurrent cohort study. Setting Don Gnocchi Foundation Institute. Participants Patients (N=351) 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. Kaplan-Meier curves were then created for time-event analysis. Results Among the patients (mean age, 64.1±15.5y), 54.1% were decannulated during their IRU stay. Absence of pulmonary infections (P<.001 sepsis tracheal alteration at the fibrobronchoscopy examination and a higher coma recovery scale-revised score or better state of consciousness admission were associated with probability decannulation.> Conclusions Fibrobronchoscopy 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. |
| Disponible en ligne : | Oui |
| En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999320302938#! |
Bibliothèques HE Vinci
