TY - JOUR
T1 - Decannulation and improvement of responsiveness in patients with disorders of consciousness
AU - Hakiki, Bahia
AU - Pancani, Silvia
AU - Draghi, Francesca
AU - Portaccio, Emilio
AU - Tofani, Ariela
AU - Binazzi, Barbara
AU - Anna Maria, Romoli
AU - Scarpino, Maenia
AU - Macchi, Claudio
AU - Cecchi, Francesca
N1 - Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/10
Y1 - 2020/10
N2 - Decannulation is a rehabilitation milestone in patients with Disorders of Consciousness (DoC). investigate the relationship between decannulation and improvement of responsiveness (IR) in DoC. 236 tracheostomized patients with severe Acquired Brain Injury and DoC admitted in the Intensive Rehabilitation Unit were retrospectively included. They received personalized interdisciplinary rehabilitation. At discharge, IR was evaluated. The association between IR and demographic/clinical data was investigated using a logistic regression analysis, both in the Unresponsive Wakefulness Syndrome (UWS) and Minimal Consciousness State (MCS) group, divided according to their Coma Recovery Scale-Revised score at admission. In the UWS group (N = 107), only decannulation was associated with IR at discharge (OR: 5.94, CI: 2.08–16.91, p =.001). In the MCS group (N = 129) time post-injury (OR: 0.983, CI: 0.97–0.99, p =.012) and decannulation were associated with IR at discharge (OR: 17.9, CI: 6.39–50.13, p <.001). Decannulation and IR were found to be strongly related, independently from the initial clinical state. While the retrospective nature of the study could not exclude that decannulation may be a consequence of a spontaneous recovery, the obtained results may disclose its potential influence on the clinical history of patients with DoC.
AB - Decannulation is a rehabilitation milestone in patients with Disorders of Consciousness (DoC). investigate the relationship between decannulation and improvement of responsiveness (IR) in DoC. 236 tracheostomized patients with severe Acquired Brain Injury and DoC admitted in the Intensive Rehabilitation Unit were retrospectively included. They received personalized interdisciplinary rehabilitation. At discharge, IR was evaluated. The association between IR and demographic/clinical data was investigated using a logistic regression analysis, both in the Unresponsive Wakefulness Syndrome (UWS) and Minimal Consciousness State (MCS) group, divided according to their Coma Recovery Scale-Revised score at admission. In the UWS group (N = 107), only decannulation was associated with IR at discharge (OR: 5.94, CI: 2.08–16.91, p =.001). In the MCS group (N = 129) time post-injury (OR: 0.983, CI: 0.97–0.99, p =.012) and decannulation were associated with IR at discharge (OR: 17.9, CI: 6.39–50.13, p <.001). Decannulation and IR were found to be strongly related, independently from the initial clinical state. While the retrospective nature of the study could not exclude that decannulation may be a consequence of a spontaneous recovery, the obtained results may disclose its potential influence on the clinical history of patients with DoC.
KW - Decannulation
KW - Disorders of consciousness
KW - Rehabilitation
KW - Severe brain injury
KW - Tracheostomy
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U2 - 10.1080/09602011.2020.1833944
DO - 10.1080/09602011.2020.1833944
M3 - Article
AN - SCOPUS:85094115715
JO - Neuropsychological Rehabilitation
JF - Neuropsychological Rehabilitation
SN - 0960-2011
ER -