RT Journal Article
SR Electronic
T1 Outcomes of patients undergoing prolonged mechanical ventilation in a post-acute care facility
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P4743
VO 44
IS Suppl 58
A1 Bertrand Herer
A1 Françoise Haniez
A1 Hélène Jaillet
A1 François Viau
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P4743.abstract
AB The aim of this study was to describe the trajectories of care of patients undergoing prolonged mechanical ventilation (PMV) via a tracheostomy in a post-acute care facility. Sixty six patients experienced 109 hospitalisations between December 2010 and December 2012 in a 36 beds post-care unit and were followed for at least 1 year. Mean age of patients was 70.4±9.9 years (39 men). The cause of respiratory failure was lung or airway disease (47%); thoracic cage abnormality (38%); neuromuscular disease (15%). The mean Charlson comorbidity score of patients was 5.6±2.0. The median length of stay (LOS) was 54 days (95% confidence interval [CI] for the median 44, 75). Patients were admitted from: home (n=44); the intensive care unit (ICU) of our hospital (n=44, LOS =24.5±22.7 days); another hospital (n=21, LOS=58.7±52.5 days, p<0.001 vs LOS in ICU). Admission diagnoses were mainly: weaning project (38%); respiratory failure (37%); respite to caregivers (11%); cachexia (6%). Twenty five (37.3%) patients were readmitted at least once during the follow-up period. Sixteen (23.9%) patients died in the hospital. Discharge destinations were home (n=78), other facility (n=11) or ICU (n=4). Twenty five (37.3%) patients were ultimately liberated from ventilator, decannulation being possible in 13 patients. At one year of the first day of hospitalisation, 60.4% of patients were alive; those who died during follow-up lived a median of 81 days (95% CI for the median 36, 125). We conclude that despite objective possibilities of 1-year survival and/or weaning from ventilation, the resources needed by PMV patients are high, as shown by the number of readmissions and long LOS in our unit and upstream.