Skip to main content

Decannulation: in the ICU or in the ward? Does it really matter?


The aim of our study was to evaluate the in-hospital mortality of patients who underwent tracheostomy during their ICU admission, and were discharged to different areas of the hospital prior to decannulation.


A prospective observational study of a group of patients who underwent tracheostomy in our ICU from January 2001 to December 2007 and were discharged to different areas of the hospital prior to decannulation. The mortality of patients decannulated or not in the wards was reviewed.


Between January 2001 and December 2007, 6,333 patients were admitted to our unit. A total of 1,528 needed mechanical ventilation (MV) for more than 48 hours. Four hundred and forty-three underwent tracheostomy (29% of patients needed prolonged MV). Mean age was 56 years, 66% were male. Mean APACHE II score was 20. The main diagnoses were polytrauma that included head injury (24.2%), other structural neurological diseases (21%), prolonged weaning of several etiologies - sepsis, post-surgical (35%). Tracheostomy was performed with the percutaneous dilatational technique (PDT) in most cases (90%). The most frequent complication was subglottic stenosis presenting in 15 patients. Ninety-two patients (20.77%) died in the ICU and 351 were discharged to different wards. Of these 351, 161 (45.8%) could be decannulated in the ICU and 109 (31%) in the wards. Eighty-one patients (23%) could not be decannulated. The ward mortality in patients decannulated in the ICU was 5.6% (9/161), for those decannulated in the wards was 10% (11/109). In patients not decannulated the mortality reached 37% (30/81). There were no differences of statistical significance in mortality between patients decannulated in the ICU and patients decannulated in the wards (5.6% vs. 10%; OR = 1.9 CI = 0.8 to 4.2). The main diagnoses in the patients who died on the wards were: 31 residual encephalopathy (post-anoxic, post-traumatic, others), five severe chronic respiratory failure, three spinal cord injury, two neuromuscular disease.


Mortality was not related to whether decannulation was done in the ICU or on the ward. Although mortality was higher in the group of patients that could not be decannulated in either setting due to their poor neurological or functional status. Several authors suggest tracheostomy in these patients only delays their death without improving overall in-hospital survival due to their poor vital prognosis.


  1. Scales DC: Crit Care Med. 2008, 36: 2547-2557. 10.1097/CCM.0b013e31818444a5

    Article  PubMed  Google Scholar 

  2. Tobin AE: Crit Care. 2008, 12: R48. 10.1186/cc6864

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Milercy, O., López, J., Figueira, J. et al. Decannulation: in the ICU or in the ward? Does it really matter?. Crit Care 15 (Suppl 1), P168 (2011).

Download citation

  • Published:

  • DOI:


  • Spinal Cord
  • Mechanical Ventilation
  • Spinal Cord Injury
  • Functional Status
  • Respiratory Failure