Factors influencing weaning from mechanical ventilation in neurological and neurosurgical early rehabilitation patients.

BACKGROUND: Studies analyzing risk factors of weaning failure in neurological and neurosurgical early rehabilitation (NNER) patients are rare.

AIM: The aim of this study was to identify clinical factors influencing the weaning of NNER patients.

DESIGN: An observational, retrospective data analysis of a German multicenter study was performed.

SETTING: German neurological early rehabilitation centers.

POPULATION: Inpatient ventilated NNER patients (N.=192) were enrolled in the study.

METHODS: Demographical data, main diagnosis, medical devices, special medical care and assessment instruments of functional abilities, consciousness and independence in activities of daily living were accrued and compared between patients with and without successful weaning. The prognostic power of factors associated with weaning success/failure was analyzed using binary logistic regression.

RESULTS: In total, 75% of the patients were successfully weaned. Colonization with multi-drug resistant bacteria and the need for dialysis were independent predictors of weaning failure. Successfully weaned patients had a shorter length of stay, better functional outcome, and lower mortality than non-successfully weaned patients.

CONCLUSIONS: Successfully weaned patients differ from patients with weaning failure in several clinical variables. All these variables are associated with the morbidity of the patient, indicating that the weaning process is strongly influenced by disease burden.

CLINICAL REHABILITATION IMPACT: Functional abilities, level of consciousness, independence in activities of daily living, colonization with multi-drug resistant bacteria, need for dialysis and disease duration might help to predict the weaning process of NNER.