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Table 2 Distribution of decannulation recommendations according to clinician and patient scenario characteristics

From: Determinants of tracheostomy decannulation: an international survey

Characteristics Decannulation recommendation P valuea
  Yes No  
  (n = 355) (n = 320)  
Clinician characteristics    
   Profession    0.860
Physician 274 (77) 245 (77)  
Respiratory therapist 81 (23) 75 (23)  
   Time since graduation in years (standard deviation) 18.9 (9.1) 18.4 (8.5) 0.452
   Principal work facility    0.041
Acute care 282 (79) 234 (73)  
Weaning 47 (13) 52 (16)  
Rehabilitation 16 (4) 14 (4)  
Chronic care 9 (2) 21 (7)  
   Experience with tracheostomized patients    0.349
0–5 years 34 (10) 44 (14)  
6–10 years 85 (24) 65 (20)  
11–20 years 134 (38) 115 (36)  
>20 years 102 (29) 96 (30)  
   Number of tracheostomy patients cared for per year    0.406
0–20 patients 62 (17) 49 (15)  
21–50 patients 101 (28) 103 (32)  
51–100 patients 128 (36) 100 (31)  
>100 patients 64 (18) 68 (21)  
   Number of tracheostomized patients decannulated per year    0.958
0–1 patients 45 (13) 39 (12)  
2–5 patients 65 (18) 52 (16)  
6–10 patients 68 (19) 64 (20)  
11–20 patients 63 (18) 57 (18)  
>20 patients 114 (32) 108 (34)  
Patient scenario characteristics    
   Scenario    0.707
Stroke 81 (23) 85 (27)  
Primary respiratory failure 84 (24) 75 (23)  
Abdominal aortic aneurysm 98 (28) 84 (26)  
Trauma 92 (26) 76 (24)  
   Age    0.103
45 years 187 (53) 147 (46)  
75 years 168 (47) 173 (54)  
   Comorbidities    0.569
None 182 (51) 157 (49)  
End-stage renal disease 173 (49) 163 (51)  
   Etiology of respiratory failure    0.030
Chronic obstructive pulmonary disease 192 (54) 144 (45)  
Pneumonia 163 (46) 176 (55)  
   Difficulty of intubation    0.089
Easy 190 (54) 149 (47)  
Difficult 165 (46) 171 (53)  
   Level of consciousness    <0.001
Alert and interactive 248 (70) 127 (40)  
Drowsy but arousable 107 (30) 193 (60)  
   Ability to tolerate capping    0.626
24 hours 174 (49) 163 (51)  
72 hours 181 (51) 157 (49)  
   Cough effectiveness    <0.001
Strong cough 221 (62) 117 (37)  
Weak cough 134 (38) 203 (63)  
   Secretions    <0.001
Scant thin 196 (55) 129 (40)  
Moderate thick 159 (45) 191 (60)  
   Swallowing function    <0.001
Nil per os 233 (66) 262 (82)  
Eating Jell-O and pudding 122 (34) 58 (18)  
   Respiratory rate    0.129
18 breaths per minute 182 (51) 146 (46)  
28 breaths per minute 173 (49) 174 (54)  
   Oxygenation, 95% saturation    
Fraction of inspired oxygen of 0.30 197 (56) 135 (42)  
Fraction of inspired oxygen of 0.50 158 (44) 185 (58) 0.001
  1. Data are expressed as number (percentage) unless otherwise indicated. aP value for the comparison of clinical case scenarios in which decannulation was recommended with those in which it was not. The 675 decannulation recommendations are clustered within 225 clinicians. P values were calculated by generalized estimating equation and robust estimates of variance.