The influence of weaning duration on rehabilitative outcome in early neurological rehabilitation.

Abstract:

BACKGROUND:We investigated if longer weaning is associated with inferior rehabilitative outcome in critical illness polyneuropathy (CIP) and cerebrovascular diseases (CVD). METHODS:We analysed retrospectively weaning protocols and medical histories of 171 tracheotomized patients with CIP and CVD. We assessed weaning durations (WD), independence in activities of daily living, as assessed by the functional independence measure (FIM), mortality rates and discharge modalities in each cohort. Weaning was performed using synchronized intermittent mandatory ventilation (SIMV) with Autoflow® and assisted spontaneous ventilation (ASV). RESULTS:WD was significantly longer in CIP compared to CVD (p < 0.001). Despite shorter in-patient treatment and longer WD, patients with CIP acquired significantly greater gains of improvement than CVD (p = 0.015). Independent living at home was possible in 43% of patients with CIP and in 26% of CVD. Mortality was equal in both groups (13% vs. 6%, p > 0.05). Chronic obstructive pulmonary disease (COPD) showed a trend towards longer weaning durations in both entities (p = 0.06). Higher age significantly correlated with longer WD (p = 0.038, r = 0.16). Longer rehabilitation duration (RD) positively correlated with higher Delta-FIM (DFIM) in both entities (p = 0.006, r = 0.21). CONCLUSION:Longer weaning and its partly negative influence on rehabilitative outcome can be compensated by longer in-patient rehabilitation in CIP and CVD.

journal_name

NeuroRehabilitation

journal_title

NeuroRehabilitation

authors

Ponfick M,Wiederer R,Bösl K,Neumann G,Lüdemann-Podubecka J,Gdynia HJ,Nowak DA

doi

10.3233/NRE-141066

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

493-8

issue

3

eissn

1053-8135

issn

1878-6448

pii

F1606266M1961551

journal_volume

34

pub_type

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