TITLE

Outcomes, cost and long term survival of patients referred to a regional weaning centre

AUTHOR(S)
Pilcher, D. V.; Bailey, M. J.; Treacher, D. F.; Hamid, S.; Williams, A. J.; Davidson, A. C.
PUB. DATE
March 2005
SOURCE
Thorax;Mar2005, Vol. 60 Issue 3, p187
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Regional weaning centres provide cost effective care for patients who have undergone prolonged mechanical ventilation. There are few published European data on outcomes in these patients. Methods: Patients admitted for weaning to the Lane Fox Respiratory Unit (LFU) between January 1997 and December 2000 were identified. The proportion weaned from mechanical ventilation, in-hospital mortality, and subsequent survival after discharge were examined. Results: A total of 153 patients had been ventilated for a median of 26 days before transfer. The daily cost per patient stay was €1350. Fifty eight patients (38%) were fully weaned, 42 (27%) died, and 53 (35%) required ventilatory support at discharge from hospital of whom 36 (24%) required only nocturnal ventilation. Univariate analysis showed increasing age (OR 1.06, p<0.001), length of ICU stay (OR 1.02, p = 0.001), APACHE II predicted risk of death score (OR 1 .02, p = 0.05), and a surgical cause for admission (OR 4.04) were associated with mortality. Neuromuscular/chest wall conditions were associated with low mortality (OR 0.36) but low likelihood of weaning from ventilation (OR 0.28). Female sex (OR 2.13, p = 0.03) and COPD (OR 2.81) were associated with successful weaning. Overall survival at 3 years from admission was 47%. Long term suvival was lowest in patients with COPD. Conclusions: Most patients survived to leave hospital, the majority having been liberated from ventilatory support. Survivors were younger and spent less time ventilated in the referring ICU. The underlying diagnosis determined success of weaning, hospital survival, and long term outcome.
ACCESSION #
16455983

 

Related Articles

  • Increasing hospital admission rates and economic burden for colorectal cancer in Brazil, 1996-2008.  // Pan American Journal of Public Health;Oct2010, Vol. 28 Issue 4, p244 

    No abstract available.

  • Relationship between intracranial pressure monitoring and outcomes in severe traumatic brain injury patients. HADDAD, S.; ALDAWOOD, A. S.; ALFERAYAN, A.; RUSSELL, N. A.; TAMIM, H. M.; ARABI, Y. M. // Anaesthesia & Intensive Care;Nov2011, Vol. 39 Issue 6, p1043 

    The article presents a study which examines the relationship between intracranial pressure (ICP) monitoring and results in patients with severe traumatic brain injury (TBI). The study reveals that ICP monitoring was related to an important increase in hospital mortality in patients with Glasgow...

  • The accuracy of diagnostic coding for acute kidney injury in England - a single centre study. Tomlinson, Laurie A.; Riding, Alex M.; Payne, Rupert A.; Abel, Gary A.; Tomson, Charles R.; Wilkinson, Ian B.; Roland, Martin O.; Chaudhry, Afzal N. // BMC Nephrology;2013, Vol. 14 Issue 1, p1 

    Background: Acute kidney injury (AKI) is an independent risk factor for mortality and is responsible for a significant burden of healthcare expenditure, so accurate measurement of its incidence is important. Administrative coding data has been used for assessing AKI incidence, and shows an...

  • Optimizing Intensive Care Unit Discharge Decisions with Patient Readmissions. Chan, Carri W.; Farias, Vivek F.; Bambos, Nicholas; Escobar, Gabriel J. // Operations Research;Nov/Dec2012, Vol. 60 Issue 6, p1323 

    This work examines the impact of discharge decisions under uncertainty in a capacity-constrained high-risk setting: the intensive care unit (ICU). New arrivals to an ICU are typically very high-priority patients and, should the ICU be full upon their arrival, discharging a patient currently...

  • BNP in the evaluation of acute dyspnea. Chambers, Christopher V.; Russell, John J. // Patient Care;Apr2004, Vol. 38 Issue 4, p40 

    Presents the results of a study that examined the effect of a diagnostic strategy incorporating a rapid assay of B-type natriuretic peptide (BNP) levels in patients with acute dyspnea. Percentage of patients evaluated and managed with the strategy that included BNP levels who were less likely...

  • No weekend effect on outcomes of severe acute pancreatitis in Japan: data from the diagnosis procedure combination database. Hamada, Tsuyoshi; Yasunaga, Hideo; Nakai, Yousuke; Isayama, Hiroyuki; Matsui, Hiroki; Fushimi, Kiyohide; Koike, Kazuhiko // Journal of Gastroenterology;Nov2016, Vol. 51 Issue 11, p1063 

    Background: In the early phase of severe acute pancreatitis, timely multidisciplinary management is required to reduce mortality. The aim of this observational study was to evaluate the impact of weekend hospital admission on outcomes using population-based data in...

  • Mesenteric Injuries after Blunt Abdominal Trauma: Delay in Diagnosis and Increased Morbidity. Shebrain, Saad; Zelada, Juliette; Lipsky, Ari M.; Putnam, Brant // American Surgeon;Oct2006, Vol. 72 Issue 10, p955 

    Mesenteric injuries after blunt abdominal trauma are infrequent and difficult to diagnose. We investigated whether a delay in diagnosis of more than 6 hours had a significant impact on morbidity, mortality, and length of stay at our Level I trauma center. A retrospective chart review spanning...

  • Cost of adverse events during hospitalisation significant.  // PharmacoEconomics & Outcomes News;7/1/2006, Issue 506, p7 

    The article discusses research being done on in-hospital adverse events in Australia. It references a study by J. P. Ehsani et al published in the June 5, 2006 issue of the "Medical Journal of Australia." Information is presented on the number of admission episodes evaluated. The average length...

  • Costos y resultados de la implementación de las guías de práctica clínica en la atención del ictus en dos hospitales de la Habana. Alina Turro Fuentes, Mercedes; García Fariñas, Anai; Gay Gómez, Mayda; María Gálvez González, Ana // Revista Cubana de Neurología y Neurocirugía;2013, Vol. 3 Issue 1, p30 

    Objective: To describe clinical outcomes and costs of patient management in acute phase using Cuban clinical practice guidelines in two health institutions in Havana. Methods: We performed a descriptive observational study, and from the axis of an economic evaluation was a description of costs...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics