Outcomes of Tracheostomized Subjects Undergoing Prolonged Mechanical Ventilation in an Intermediate-Care Facility.

BACKGROUND: The incidence of chronically ill subjects with prolonged mechanical ventilation (PMV) has significantly increased over the last decade because of improvements in acute critical care. The aim of this study was to describe the outcomes and care pathways of subjects receiving PMV through a...

Descripción completa

Detalles Bibliográficos
Publicado en:Respiratory Care Vol. 63; no. 3; pp. 282 - 289
Autor principal: Herer, Bertrand
Formato: CEU research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Mar2018
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=128238630&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 128238630
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        00201324
        4GG
      jtl: Respiratory Care
      issn: 00201324
      maglogo: N
    pubinfo:
      dt: Mar2018
      vid: 63
      iid: 3
      pid: 1365
      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
    artinfo:
      ui:
        128238630
        128238630
        128238630
        10.4187/respcare.05602
        128238630
      ppf: 282
      ppct: 7
      formats:
        fmt:
          @attributes:
            type: P
      tig:
        atl: Outcomes of Tracheostomized Subjects Undergoing Prolonged Mechanical Ventilation in an Intermediate-Care Facility.
      aug:
        au: Herer, Bertrand
        affil: Centre Hospitalier de Bligny, Briis-Sous-Forges, France
      sug:
        subj:
          Tracheostomy
          Respiration, Artificial
          Treatment Duration
          Treatment Outcomes
          Subacute Care
          Respiratory Failure Therapy
          Education, Continuing (Credit)
          Human
          Descriptive Statistics
          Length of Stay
          Retrospective Design
          P-Value
          Readmission
          Health Facilities
          Hospital Mortality
          Skilled Nursing Facilities
          Patient Discharge
          Transfer, Discharge
          Ventilator Weaning
          France
          Clinical Assessment Tools
          Male
          Female
          Aged, 80 and Over
          Aged
          Middle Age
          Chi Square Test
          Kaplan-Meier Estimator
          Unpaired T-Tests
          Cox Proportional Hazards Model
          Data Analysis Software
          Confidence Intervals
          Relative Risk
          Aged, 80 & over
          Aged: 65+ years
          Middle Aged: 45-64 years
          Male
          Female
      ab: BACKGROUND: The incidence of chronically ill subjects with prolonged mechanical ventilation (PMV) has significantly increased over the last decade because of improvements in acute critical care. The aim of this study was to describe the outcomes and care pathways of subjects receiving PMV through a tracheostomy tube in an intermediate-care facility. METHODS: Sixty-six subjects with chronic respiratory failure who experienced 109 hospitalizations between December 2010 and December 2012 in a 34-bed post-care unit were retrospectively included and followed for at least 1 y. RESULTS: The median (interquartile range [IQR]) length of stay (LOS) was 42 (26-77) d. Subjects were admitted from home (40.4%), our hospital ICU (40.4%; median [IQR] LOS = 17 [7-38] d), or another hospital (19.2%; median [IQR] LOS = 60 [8-71] d, P = .001 vs LOS in ICU). Thirty-five percent of subjects were readmitted at least once during the follow-up period. Sixteen subjects died in the intermediate-care facility. Discharge destinations of alive subjects were home (n = 78), another hospital (n = 6), a skilled-nursing facility (n = 5), or an ICU (n = 4). A complete or partial weaning was obtained in 30.3% of subjects. One year after the first day of hospitalization, 57% of subjects were alive. CONCLUSIONS: Despite the chance of survival at 1 y and/or weaning from ventilation, the resources needed by subjects with PMV are high, as shown by the number of readmissions and long LOS in our unit and in other hospital units before transfer.
      pubtype: Academic Journal
      doctype:
        CEU
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N