ArticleFrontiers in neurology2025
Weaning in early neurological-neurosurgical rehabilitation in Germany - results from a nationwide online survey.
Article in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: In Germany, approximately 1,100 beds are allocated to early neurological-neurosurgical rehabilitation (ENNR) for patients with severe neurological illness requiring weaning from mechanical ventilation. Specialized ENNR institutions play a major role in maintaining ICU capacity in acute care hospitals and in reducing the number of patients dependent on home intensive care. However, nationwide structural data on ENNR weaning centers-together with detailed patient characteristics-remain unavailable. This lack of information poses significant challenges for healthcare planning, resource allocation, and understanding the national weaning capacity. Methods: In June 2022, an online survey was conducted to collect structural data on institutions and wards, as well as cross-sectional clinical data from mechanically ventilated neurological patients. The survey was sent to the members of the weaning commission of the German Society for Neurological Rehabilitation (DGNR), to participants of a preceding study, and also to institutions recruited through personal communication. Findings: Data were collected from 24 institutions, including 46 wards and 182 patients. Institutions showed considerable variability in diagnostic and therapeutic resources; however, most relied on multidisciplinary teams and intensive monitoring, indicating high medical complexity of the patient population. The most frequent primary diagnoses included ischemic stroke ( Interpretation: Institutions providing weaning in ENNR commonly treat older, medically complex patients who have undergone pretreatment in acute intensive care units. These patients typically present with severe neurological illness accompanied with cardiopulmonary comorbidities. In order to meet their needs, multidisciplinary teams deliver rehabilitation, intensive care, and palliative care.
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