{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T16:21:44Z","timestamp":1769358104162,"version":"3.49.0"},"reference-count":34,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T00:00:00Z","timestamp":1646265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Rehabilitation outcomes of difficult-to-wean tracheostomized patients have been reported in relatively small case studies and described for a limited time span. This study describes the characteristics and clinical outcomes of a large cohort of tracheostomized patients admitted to a specialized weaning unit over 10 years. We retrospectively analyzed data collected from January 2010 to December 2019 on difficult-to-wean tracheostomized patients who underwent comprehensive rehabilitation. Clinical characteristics collected at admission were the level of comorbidity (by the Cumulative Illness Rating Scale\u2014CIRS) and the clinical severity (by the Simplified Acute Physiology Score\u2014SAPS II). The proportions of patients weaned, decannulated, and able to walk; the change in autonomy level according to the Bristol Activities of Daily Living (BADL) Scale; and the setting of hospital discharge was assessed and compared in a consecutive 5-year time period (2010\u20132014 and 2015\u20132019) subgroup analysis. A total of 180 patients were included in the analysis. Patient anthropometry and preadmission clinical management in acute care hospitals were similar across years, but the categories of underlying diagnosis changed (p &lt; 0.001) (e.g., chronic obstructive pulmonary disease\u2014COPD\u2014decreased), while the level of comorbidities increased (p = 0.003). The decannulation rate was 45.6%. CIRS and SAPS II at admission were both significant predictors of clinical outcomes. The proportion of patients whose gain in BADL score increased \u2265 2 points decreased over time. This study confirms the importance of rehabilitation in weaning units for the severely disabled subset of tracheostomized patients. Comorbidities and severity at admission are significantly associated with rehabilitation outcomes at discharge.<\/jats:p>","DOI":"10.3390\/ijerph19052982","type":"journal-article","created":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T20:36:30Z","timestamp":1646339790000},"page":"2982","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Rehabilitation of Difficult-to-Wean, Tracheostomized Patients Admitted to Specialized Unit: Retrospective Analyses over 10-Years"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4645-0336","authenticated-orcid":false,"given":"Stefania","family":"Costi","sequence":"first","affiliation":[{"name":"Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine CHIMOMO, University of Modena and Reggio Emilia, 41121 Modena, Italy"},{"name":"Physical Medicine and Rehabilitation Unit, Azienda Unit\u00e0 Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Brogneri","sequence":"additional","affiliation":[{"name":"Respiratory Rehabilitation of Ospedale Villa Pineta-KOS Group, 41026 Pavullo nel Frignano (MO), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3125-4591","authenticated-orcid":false,"given":"Chiara","family":"Bagni","sequence":"additional","affiliation":[{"name":"School of Physiotherapy, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine CHIMOMO, University of Modena and Reggio Emilia, 41121 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Pennacchi","sequence":"additional","affiliation":[{"name":"School of Physiotherapy, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine CHIMOMO, University of Modena and Reggio Emilia, 41121 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Beneventi","sequence":"additional","affiliation":[{"name":"Respiratory Rehabilitation of Ospedale Villa Pineta-KOS Group, 41026 Pavullo nel Frignano (MO), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Tabb\u00ec","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Unit, Department of Medical and Surgical Sciences SMECHIMAI, University Hospital of Modena, University of Modena and Reggio Emilia, 41121 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Dell\u2019Orso","sequence":"additional","affiliation":[{"name":"Respiratory Rehabilitation of Ospedale Villa Pineta-KOS Group, 41026 Pavullo nel Frignano (MO), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riccardo","family":"Fantini","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Unit, Department of Medical and Surgical Sciences SMECHIMAI, University Hospital of Modena, University of Modena and Reggio Emilia, 41121 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6202-0758","authenticated-orcid":false,"given":"Roberto","family":"Tonelli","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Unit, Department of Medical and Surgical Sciences SMECHIMAI, University Hospital of Modena, University of Modena and Reggio Emilia, 41121 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianfranco Maria","family":"Beghi","sequence":"additional","affiliation":[{"name":"Respiratory Rehabilitation of Ospedale Villa Pineta-KOS Group, 41026 Pavullo nel Frignano (MO), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1515-5094","authenticated-orcid":false,"given":"Enrico","family":"Clini","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Unit, Department of Medical and Surgical Sciences SMECHIMAI, University Hospital of Modena, University of Modena and Reggio Emilia, 41121 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1164\/rccm.201411-2011ST","article-title":"An official American Thoracic Society Clinical Practice guideline: The diagnosis of intensive care unit-acquired weakness in adults","volume":"190","author":"Fan","year":"2014","journal-title":"Am. 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