Decannulation Following Tracheostomy for Prolonged Mechanical Ventilation

BACKGROUND: We examined the process of decannulation following tracheostomy in patients transferred to a long-term acute care (LTAC) hospital for weaning from prolonged mechanical ventilation (PMV). METHODS: A retrospective chart review of 135 patients. RESULTS: Decannulation was successful in 35% of patients a median of 45 days (IQR, 32-76) following tracheostomy. Patients who failed decannulation had a tracheostomy tube placed earlier (14 days; IQR 11-18 vs. 18 days; IQR 14-30, P=.04) and had a shorter length of stay at the acute facility (20 days; IQR, 16-23 vs. 31 days; IQR 24-45, P=.003) compared with patients who were decannulated. Length of stay and cost of care at the LTAC did not differ with decannulation status. At 3.5 years, 35% (47/135) of all patients and 62% (29/47) of decannulated patients were alive. CONCLUSIONS: Decannulation was achieved in 35% of patients transferred to an LTAC for weaning from prolonged mechanical ventilation.