The influencing factors for tracheostomy decannulation after traumatic cervical spinal cord injury: a retrospective study.

Study Design: Retrospective study.

Objective: To investigate the outcomes and influencing factors of tracheostomy decannulation (TD) in persons with traumatic cervical spinal cord injury (SCI).

Setting: China Rehabilitation Research Center (CRRC) in Beijing, China.

Methods: From January 2017 to December 2021, 365 persons with traumatic cervical SCI were admitted to the China Rehabilitation Research Center. During hospitalization, tracheostomy patients were enrolled and divided into the TD group and non-TD group. Demographic and clinical data, as well as functional assessments, were collected and recorded for all persons. The factors influencing TD were analyzed using both univariate and multivariate logistic regression.

Results: A total of 78 persons with traumatic cervical SCI from CRRC were enrolled in this study. Of these, 48 persons (61.5%) underwent successful decannulation, with a median time of 93.5 days (IQR: 62.0-143.8 days). Multivariate logistic regression revealed that AIS A (P = 0.021, OR: 5.378, 95% CI, 1.287-22.474) and Charlson comorbidity index (CCI) (P = 0.003, OR: 1.836, 95% CI, 1.230-2.740) were significant risk factors of reduced success in TD. PEF in the TD group was 145.44 ± 50.56 L/min. Middle-aged and young persons with traumatic cervical SCI at C3 to C5 neurological level did not satisfy the criterion of PEF (over 160 L/min), but they can still attempt tracheostomy decannulation.

Conclusion: AIS A and a high CCI will reduce the success rate of tracheostomy decannulation in persons suffering from traumatic cervical SCI.