Tracheostomy Decannulation: Traditional Method vs Single Stage Comparison

Objective: To evaluate the predictive relationship between independent variables (age, sex, BMI, hypertension, diabetes mellitus, chronic obstructive pulmonary disease (COPD), stroke, heart disease, pychiatric history and seizures, and successful tracheostomy decannulation (TD) with either the traditional method or single-stage method. Study Design: Retrospective chart review of both in-patient and out-patient clinic charts between the periods of January 1, 2013 and July 31, 2020 at Detroit Medical Center for information related to TD. Methods: Inclusion criteria include any patient diagnosed with tracheostomy status over the age of 18 years with decannulation. Exclusion criteria included no information about tracheostomy decannulation, i.e. incomplete medical records. Tracheostomy patients who underwent traditional TD (with capping trial) were compared to those who underwent newer single-stage TD (without capping trial). Chi-square analysis, multinomial regression analysis and t tests were performed to assess if there was a significant difference in successful TD between traditional method versus single-stage method. Binary dependent variable and independent variable relationship were analyzed with multinomial regression analysis with p<0.05 indicate a statistical significance. Results: Only 93 met the inclusion and exclusion criteria after 115 patient charts review. Majority of subjects were males 57% (n=53) .Oldest patient age was 81 years (mean=54.08; SD= 11.449). 49 was the highest BMI (mean=28.2; SD=6.86). There was no statistically significant difference between mean in age, sex, BMI, hypertension, diabetes mellitus, COPD, stroke, heart disease, psychiatric history, and seizures. Conclusion: This study showed the age, sex, BMI, hypertension, diabetes mellitus, COPD, stroke, heart disease, psychiatric history, and seizures are not significant indicators for successful TD in either method.