ArticleEuropean journal of physical and rehabilitation medicine2023
Severe secretion retention: a predictor of decannulation outcome in severe brain injury patients with tracheostomy.
Article in European journal of physical and rehabilitation medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 10 citations in OpenAlex.
- Enhancing Swallowing Function in Tracheotomy Patients with Subglottic Oxygen Flow: A Randomized Self-Controlled Crossover Trial.Dysphagia · 2026Trial
- Lightning Strike-Induced Cutaneous Burns and Airway Injury: A Case Report Highlighting Recurrent Extubation Failure in a Critically Ill Patient.European burn journal · 2026Article
- Tracheostomy Decannulation Practices in Indian Intensive Care Units: A National Cross-sectional Survey of Intensive Care Unit Consultants.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Article
- An Artificial Intelligence Approach to Predict Tracheostomy Requirement in Mechanically Ventilated Critically Ill Patients: A Retrospective Single-Center Study.Journal of clinical medicine · 2026Article
- Predictors of successful decannulation in patients with chronic disorders of consciousness and tracheostomy.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Bronchoscopy-guided non-capping decannulation pathway versus conventional capping trial in patients with prolonged tracheostomy: a retrospective comparative cohort study.Frontiers in medicine · 2026Article
- Predictive Factors of Successful Decannulation in Tracheostomy Patients: A Scoping Review.Journal of clinical medicine · 2025Review
- A stepwise decannulation pathway for patients with prolonged disorders of consciousness after brain injury: a retrospective feasibility study.Frontiers in neurologyArticle
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIdentifying accurate predictors of decannulation outcome is essential to ensure safe and timesaving decannulation. Studies indicated hypopharyngeal secretion retention is closely associated with compromised airway protection and patients with it are less likely to be decannulated. However, data verifying the link between secretion retention and decannulation outcome are lacking.
aimThe aim of this study was to identify the association between hypopharyngeal secretion-retention (indicated by Murray Secretion Scale [MSS]) and decannulation outcomes in a large cohort of severe acquired brain injury (sABI) patients with tracheotomy. To test the diagnostic performance of secretion retention in decision making of decannulation.
designRetrospective cross-sectional study.
settingThe setting of the study is neurorehabilitation department in a tertiary teaching hospital. POPULATION: A total of 144 adult patients with sABI and tracheostomy were retrospectively selected from the database from September 1, 2019, to August 31, 2021.
methodsThe results of hypopharyngeal secretion-retention observed by fiberoptic endoscopy on the day that decision on decannulation was made were collected. The association between severity of secretion retention and decannulation outcomes was investigated through logistic regression, which was used to adjust covariates, including presence of food/liquid aspiration, decreased laryngeal sensation and conscious level. The optimal cut-off values of MSS for decannulation status prediction was determined by maximizing the Youden Index.
resultsOne hundred twenty-one patients were included in the sample. The age was 55.6±15.2 years, 84 (69.4%) patients were male. Eighty-four (69.4%) of them were successfully decannulated during their hospital stay. Multivariable logistic regression analysis indicated severe secretion retention (MSS level3) was independently associated with prolonged tracheostomy (adjusted odds ratio 65.23, 95% CI 6.58-646.35, P<0.001). The sensitivity and specificity of MSS level3 to assess the probability of prolonged decannulation were 78.4% and 96.4%, respectively. The area under the curve was 0.894 (95% CI 0.819-0.969).
conclusionsOur results add to the evidence supporting screening of secretion retention severity in sABI population to identify patients at risk of prolonged tracheostomy. Whether decreasing secretion retention increases probability of successful decannulation deserves to be investigated by further study. CLINICAL REHABILITATION IMPACT: This study could provide evidence for establishing objective decannulation criteria based on fiberoptic endoscopy and be helpful for implementing targeted rehabilitation interventions to promote successful decannulation.
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