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The Impact of Mechanical Ventilation Duration on the Readmission to Intensive Care Unit: A Population-Based
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
Background:
If the duration of mechanical ventilation (MV) is related with the intensive care unit (ICU) readmission must be clarified. The purpose of this study was to elucidate if prolonged MV duration increases ICU readmission rate.
Methods:
The present observational cohort study analyzed national healthcare claims data from 2006 to 2015. Critically ill patients who received MV in the ICU were classified into five groups according to the MV duration: MV for <7 days, 7-13 days, 14-20 days, 21-27 days, and ≥28 days. The rate and risk of the ICU readmission were estimated according to the MV duration using the unadjusted and adjusted analyses.
Results:
We found that 12,929 patients had at least one episode of MV in the ICU. There was a significant linear relationship between the MV duration and the ICU readmission (R2=0.85, p=0.025). The total readmission rate was significantly higher as the MV duration is prolonged (MV for <7 days, 13.9%; for 7-13 days, 16.7%; for 14-20 days, 19.4%; for 21-27 days, 20.4%; for ≥28 days, 35.7%; p<0.001). The analyses adjusted by covariables and weighted with the multinomial propensity scores showed similar results. In the adjusted regression analysis with a Cox proportional hazards model, the MV duration was significantly related to the ICU readmission (hazard ratio, 1.058 [95% confidence interval, 1.047-1.069], p<0.001).
Conclusion:
The rate of readmission to the ICU was significantly higher in patients who received longer durations of the MV in the ICU. In the clinical setting, closer observation of patients discharged from the ICU after prolonged periods of MV is required.
Insights
Prolonged mechanical ventilation (MV) significantly increases intensive care unit (ICU) readmission rates. Patients requiring longer MV durations face a higher risk of returning to the ICU, necessitating closer post-discharge observation.
Area of Science:
- Critical Care Medicine
- Health Services Research
Background:
- Mechanical ventilation (MV) is a life-support measure for critically ill patients.
- The relationship between MV duration and intensive care unit (ICU) readmission requires clarification.
Purpose of the Study:
- To determine if prolonged mechanical ventilation duration is associated with an increased rate of ICU readmission.
Main Methods:
- An observational cohort study analyzed national healthcare claims data (2006-2015).
- Critically ill patients receiving MV were categorized by ventilation duration (<7, 7-13, 14-20, 21-27, ≥28 days).
- ICU readmission rates and risks were analyzed using unadjusted and adjusted models.
Main Results:
- A significant linear relationship was observed between MV duration and ICU readmission (R²=0.85, p=0.025).
- Readmission rates increased with prolonged MV duration, reaching 35.7% for those on MV ≥28 days (p<0.001).
- Adjusted analyses confirmed MV duration as a significant predictor of ICU readmission (HR, 1.058; p<0.001).
Conclusions:
- Longer durations of mechanical ventilation in the ICU are associated with significantly higher ICU readmission rates.
- Patients discharged from the ICU after prolonged MV require closer clinical observation.
- This finding underscores the importance of monitoring patients with extended ventilation support.
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