The impact of early surgical treatment of tracheal stenosis on neurorehabilitation outcome in patients with severe acquired brain injury

ABSTRACT

Introduction

Acquired tracheal stenosis (TS) is a potentially life-threatening condition following prolonged intubation and/or tracheostomy in adult patients with severe Acquired Brain Injury (sABI), requiring a tracheal resection and reconstruction.

Methods

We included 38 sABI adult patients with TS, admitted at a post-acute Neurorehabilitation Hospital. Disability Rating Scale (DRS) and other functional assessment measures were recorded at admission (t₁), before TS surgical treatment (t₂), and at discharge (t₃). Patients were defined as ‘improved’ when they changed from a more severe to a less severe disability, between time t₂ and time t₃, and as “not improved” when they did not show any further improvement between t₂ and t₃, or they already exhibited a disability improvement since time interval t₁-t₂.

Results

Time interval between the injury onset and TS surgical treatment (t₂-t₀) was associated with the patient’s disability improvement, suggesting the t₂-t₀ time interval ≤ 115 days as a cutoff value for a possible functional recovery. A t₂-t₀ time interval ≤ 170 days is also associated to absence of persistent dysphagia.

Conclusions

Early TS surgical treatment within 115 days from the injury onset contributes to the improvement of the disability level in patients with sABI, optimizing their functional outcomes and recovery potential.

KEYWORDS:

• tracheal stenosis
• severe acquired brain injury
• disability rating scale
• rehabilitation outcome

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contribution statement

RF and MDI made substantial contributions to study conception and design, and in drafting the manuscript. MDI also contributed to data acquisition. CM contributed to data acquisition and reviewed the manuscript critically. MG performed the analysis and interpretation of data.

All Authors contributed significantly to the content of the article, and gave the final approval of the version to be submitted.

Additional information

Funding

No funding to declare.