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Aims To determine the patient factors associated with tracheostomy-related pressure injury (TRPI) using a multilevel, multivariate logistic regression model and to evaluate how care during the COVID-19 pandemic affected TRPI and its predictors. Design Secondary data analysis of a tracheostomy patient database and electronic medical records. Methods This secondary data analysis study will merge and analyze data from the Global Tracheostomy Collaborative and the electronic health records of a large US healthcare system. We will employ a multilevel logistic regression model to investigate the relationships between suspected risk factors for TRPI. Discussion Given the impact of TRPI on patient outcomes and expenditures, it is imperative to standardize TRPI assessment, increase awareness of at-risk patient populations, and implement novel preventive modalities. This will be the first large-sample study …