{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T15:11:24Z","timestamp":1782573084139,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp;amp; Comm Disor"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tracheostomy management aims to achieve optimal decannulation outcomes in tracheostomized patients. Successful removal of the tracheal cannula (decannulation) is key from a physical and psychological health perspective. Decannulation success is commonly defined as the absence of physical complications leading to re\u2010cannulation within a few hours or days post\u2010decannulation. However, this definition does not account for complications occurring weeks or months later, or for (serious) complications that require actions other than re\u2010cannulation. Additionally, the definition neglects the patients\u2019 experience of the decannulation outcome. This manuscript outlines the protocol of a study designed to comprehensively evaluate decannulation outcomes long\u2010term, incorporating both physical and psychological variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This longitudinal, prospective, single\u2010centre mixed\u2010methods observational study entitled \u2018Outcomes of tracheostomy decannulation: A longitudinal observational study\u2019 aims to include a consecutive sample of 150 adult inpatients hospitalized in a large neurological rehabilitation centre specialized for spinal cord injury and prolonged weaning. Adult inpatients of various diagnoses who have undergone tracheostomy are eligible for inclusion if decannulation is sought and occurs in the study centre and if they are able to communicate in German, French, Italian, or English. Outcomes of interest include the rate and type of physical complications (occurring up to 3 months post\u2010decannulation) and the consequences (e.g., intubation), the patients\u2019 view on benefits\/harms of decannulation, and human flourishing pre\u2010 and post\u2010decannulation. Candidate prognostic variables for complications post\u2010decannulation are examined 1 week prior to decannulation and 1 month and 3 months post\u2010decannulation. Data relating to the decannulation process, including decannulation criteria, will be recorded. Complication rates will be evaluated over 3 months post\u2010decannulation using Kaplan\u2013Meier and Nelson\u2013Aalen estimators and time\u2010to\u2010event analysis. Decannulation\u2010related complications will be descriptively analysed. Longitudinal changes in patient perspectives on decannulation outcomes are qualitatively and descriptively assessed, and the distribution across groups with and without complications is assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>A comprehensive understanding of physical and psychological decannulation outcomes will build the basis for optimized clinical decisions related to tracheostomy management and guide the development of an evidence\u2010based clinical guideline for decannulation management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifier: NCT06047665<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WHAT THIS PAPER ADDS<\/jats:title>\n                    <jats:p>\n                      <jats:italic>What is already known on the subject<\/jats:italic>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Tracheostomy management is a multidisciplinary task and targets a timely and safe removal of the tracheal cannula (decannulation).<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Successful decannulation is key from a physical and psychological health perspective.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Decannulation success is commonly defined as the absence of physical complications leading to re\u2010cannulation within a few hours or days post\u2010decannulation (short\u2010term).<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:italic>What this paper adds to existing knowledge<\/jats:italic>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>This study evaluates a variety of physical decannulation outcomes (including complications that do not result in a re\u2010cannulation) for 3 months post\u2010decannulation (long\u2010term).<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Patients\u2019 perspective on decannulation outcomes are assessed as the views of those affected are key for a comprehensive assessment of decannulation outcomes.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:italic>What are the potential or actual implications of this work?<\/jats:italic>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>The data will build a foundation for optimized clinical decision\u2010making related to decannulation management.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>The study will guide patient care pre\u2010 and post\u2010decannulation to support positive long\u2010term decannulation outcomes, reduce decannulation related medical and psychological sequalae, and contribute to economic decannulation management in relation to health care costs.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>This research will inform the development of an evidence\u2010based clinical decannulation guideline.<\/jats:p>\n                        <\/jats:list-item>\n                      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