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Mortality and Readmission Among Ventilator-dependent Patients After Successful Weaned Discharge From a Respiratory Care Ward
- Source :
- Journal of the Formosan Medical Association, Vol 109, Iss 6, Pp 446-455 (2010)
- Publication Year :
- 2010
- Publisher :
- Elsevier, 2010.
-
Abstract
- Background/Purpose Patients on prolonged mechanical ventilation in Taiwan are stepped down to a respiratory care ward (RCW) for further respiratory care. Only a few patients in the RCW can ultimately be weaned and discharged. In this study, we tried to determine factors that predict mortality and readmission of these patients in the post-discharge period. Methods Between May 1, 2004 and October 31, 2006, clinical data were retrospectively analyzed for eligible patients in a RCW. Patients who were successfully weaned from mechanical ventilation were enrolled in this study. Results A total of 243 patients were eligible for evaluation, and 67 patients were successfully weaned and discharged. By Kaplan-Meier curve, 36 (67.1%) patients were readmitted within 3 months after discharge, and among these, 23 (63.9%) had mechanical ventilation reinstituted at the time of first readmission. The most common cause of readmission was airway infection (80.5%). Overall mortality and readmission rates at 1 year after weaned discharge were 32.9% and 88.2%, respectively. By multivariate analysis, patients with neurologic causes of ventilator dependency were less likely to be readmitted (hazard ratio = 0.36; p =0.034), and neoplastic diseases (hazard ratio = 4.66; p =0.031) were independently associated with mortality. Conclusion Underlying comorbidities and causes of ventilator dependency are important predictors of mortality and readmission among patients after weaned discharge from a RCW.
- Subjects :
- Male
medicine.medical_specialty
Pediatrics
Multivariate analysis
Critical Care
medicine.medical_treatment
Taiwan
Comorbidity
Kaplan-Meier Estimate
prolonged mechanical ventilation
Patient Readmission
medicine
Humans
Respiratory Care Units
Aged
Retrospective Studies
Mechanical ventilation
Medicine(all)
Aged, 80 and over
lcsh:R5-920
business.industry
readmission
weaning
Hazard ratio
Retrospective cohort study
General Medicine
Length of Stay
medicine.disease
mortality
Treatment Outcome
Emergency medicine
Multivariate Analysis
Female
Airway
business
Respiratory Insufficiency
lcsh:Medicine (General)
Ventilator Weaning
Respiratory care
respiratory care ward
Follow-Up Studies
Subjects
Details
- Language :
- English
- ISSN :
- 09296646
- Volume :
- 109
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Journal of the Formosan Medical Association
- Accession number :
- edsair.doi.dedup.....f291096755ce214974b9d85d8b1706cb