Using Routinely Gathered Clinical Data to Develop a Prognostic Online Tool for Decannulation in Subjects With Acquired Brain Injury.
BACKGROUND: Clinicians are often required to provide a qualified guess on the probability of decannulation in estimating patients' rehabilitation potential and relaying information about prognosis to patients and next of kin. The objective of this study was to use routinely gathered clinical data to...
| Publicado en: | Respiratory Care Vol. 65; no. 11; pp. 1678 - 1687 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Nov2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=146553850&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 146553850 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Nov2020 vid: 65 iid: 11 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 146553850 146553850 146553850 10.4187/respcare.07497 146553850 ppf: 1678 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Using Routinely Gathered Clinical Data to Develop a Prognostic Online Tool for Decannulation in Subjects With Acquired Brain Injury. aug: au: Mortensen, Jesper Svanborg Kjeldsen, Simon Honoré, Helene Roer Pedersen, Asger affil: Research Unit, Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark sug: subj: Brain Injuries Prognosis Tracheostomy Medical Practice Human Data Collection Methods Prospective Studies Patient Admission Odds Ratio Rehabilitation Centers Deglutition Functional Assessment Cerebrovascular Disorders Stroke Information Technology Swallowing Therapy Denmark Adolescence Adult Middle Age Aged Logistic Regression Descriptive Statistics Confidence Intervals Models, Statistical Male Female Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: BACKGROUND: Clinicians are often required to provide a qualified guess on the probability of decannulation in estimating patients' rehabilitation potential and relaying information about prognosis to patients and next of kin. The objective of this study was to use routinely gathered clinical data to develop a prognostic model of time to decannulation in subjects with acquired brain injury, for direct implementation in clinical practice. METHODS: Data from a large cohort including 574 tracheostomized subjects admitted for neurorehabilitation were analyzed using discrete time-to-event analysis with logit-link. Within this model, a reference hazard function was modeled using restricted cubic splines, and estimates were presented using odds ratios (95% CIs). RESULTS: A total of 411 subjects (72%) were decannulated within a median of 27 d (interquartile range 16-49) at the rehabilitation hospital. The prognostic model for decannulation included age, diagnosis, days from injury until admission for rehabilitation, swallowing, and overall functional level measured with the Early Functional Abilities score. Among these, the strongest predictors for decannulation were age and a combination of overall functional abilities combined with swallowing ability. CONCLUSIONS: A prognostic model for decannulation was developed using routinely gathered clinical data. Based on the model, an online graphical user interface was applied, in which the probability of decannulation within x days is calculated along with the statistical uncertainty of the probability. Furthermore, a layman's interpretation is provided. The online tool was directly implemented in clinical practice at the rehabilitation hospital, and is available through this link: (http://www.hospitalsenhedmidt.dk/regionshospitalet-hammel/research-unit/Prognosissoftware/). pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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