Predictors Of Extubation Time In Patients With Tracheotomy After Ischemic Stroke

Objective: In this study,we analyzed factors related to extubation time in post-stroke patients with tracheotomy.Patients and methods: This was a retrospective study.The conducted to evaluate patients who had undergone tracheotomy and were hospitalized at the Rehabilitation Department of the First Affiliated Hospital of Nanchang University from January 2013 to December 2020.Patients were divided into two groups according to whether the catheter time was more than 30 days.Univariate logistic regression analysis was used to explore the the duration of indwelling metal cannulas in post-stroke patients with tracheotomy.To prevent omission of relevant factors,variables with P-value < 0.1,as determined by univariate analysis,were further analyzed using multivariate logistic regression.Our results show that the variables with P-value < 0.05,as determined using multivariate analysis,were statistically significant.Results:Multivariate logistic regression analysis showed that increased age [OR(95%CI)=6.305(2.097-18.957),P=0.001],increased National Institutes of Health Stroke Scale score(NIHSS)[OR(95%CI)=7.846(2.775-22.182),P<0.001]and presence of pulmonary infection[OR(95%CI)= 7.697(1.414-41.895),P=0.018]increased,while phrenic nerve stimulation [ OR(95%CI)=0.192(0.067-0.546),P=0.002]decreased the duration of indwelling metal cannulas in post-stroke patients with tracheotomy.Conclusion: Age,increased NIHSS score and presence of pulmonary infection were independent risk factors for extubation time in post-stroke patients with tracheotomy;phrenic-nerve stimulation was the only protective factor.Sex,dysphagia,moist rales,albumin level and impaired state of consciousness were potential risk factors for,while respiratory training was a potential protective factor against the extubation time.The findings obtained in our present study can guide decisions regarding decannulation in patients with stroke.