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Post-ICU mechanical ventilation at 23 long-term care hospitals: a multicenter outcomes study.

Abstract：

STUDY OBJECTIVES:This multicenter study was undertaken to characterize the population of ventilator-dependent patients admitted to long-term care hospitals (LTCHs) with weaning programs, and to report treatments, complications, weaning outcome, discharge disposition, and survival in these patients. DESIGN:Observational study with concurrent data collection. SETTING:Twenty-three LTCHs in the United States. PATIENTS:Consecutive ventilator-dependent patients admitted over a 1-year period: March 1, 2002, to February 28, 2003. RESULTS:A total of 1,419 patients were enrolled in the Ventilation Outcomes Study. Median age of patients was 71.8 years (range, 18 to 97.7 years). Patients averaged 6.9 procedures and treatments during the LTCH hospitalization; median length of stay was 40 days (range, 1 to 365 days). Seven of the 10 most frequent complications treated at the LTCH were infections; congestive heart failure and diabetes mellitus were the most common comorbidities requiring treatment. Outcomes of weaning attempts, scored at LTCH discharge, were 54.1% weaned, 20.9% ventilator dependent, and 25.0% deceased. Median time to wean (n = 766) was 15 days (range, 7 to 30 days). Discharge disposition included 28.8% to home, 49.2% to rehabilitation and extended-care facilities, and 19.5% to short-stay acute hospitals. Nearly one third of patients were known to be alive 12 months after admission to the LTCH. CONCLUSIONS:Patients admitted to LTCHs for weaning attempts were elderly, with acute-on-chronic diseases, and continued to require considerable medical interventions and treatments. The frequency and type of complications were not surprising following prolonged and aggressive ICU interventions. In the continuum of critical care medicine, more than half of ventilator-dependent survivors of catastrophic illness transferred from the ICU were successfully weaned from prolonged mechanical ventilation in the setting of an LTCH.

journal_name

Chest

journal_title

Chest

authors

Scheinhorn DJ,Hassenpflug MS,Votto JJ,Chao DC,Epstein SK,Doig GS,Knight EB,Petrak RA,Ventilation Outcomes Study Group.

doi

10.1378/chest.06-1081

subject

Has Abstract

pub_date

2007-01-01 00:00:00

pages

85-93

issue

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(15)49884-8

journal_volume

131

pub_type

杂志文章,多中心研究

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Post-ICU mechanical ventilation at 23 long-term care hospitals: a multicenter outcomes study.