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Outcomes of long-term ventilator patients: a descriptive study
S L Douglas1, B J Daly, P F Brennan
1Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA.
Summary
Many intensive care unit (ICU) patients needing prolonged mechanical ventilation (MV) do not survive or require extended care post-discharge. Discussing these outcomes with families is crucial for informed decision-making.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Geriatrics
Background:
- Prolonged mechanical ventilation (MV) is increasingly common in intensive care units (ICUs).
- Limited research exists on the characteristics and post-hospital outcomes of these long-term ICU patients.
- This population represents a significant and growing healthcare cost.
Purpose of the Study:
- To characterize the clinical and sociodemographic profiles of ICU patients requiring long-term MV (≥5 days).
- To determine the in-hospital and post-discharge outcomes, including disposition and mortality, for this patient group.
Main Methods:
- A prospective, longitudinal descriptive study design was employed.
- Fifty-seven ICU patients requiring continuous MV for 5 days or more were enrolled.
- Data collection included clinical and sociodemographic information, with follow-up for up to 6 months post-discharge to assess outcomes.
Main Results:
- Patients averaged nearly 6 weeks in the hospital and 4 weeks on MV.
- Hospital mortality was high at 43.9%.
- Among survivors, none initially returned home independently; at 6 months, over 50% had died, 9% were institutionalized, and 33% were home.
Conclusions:
- A substantial proportion of long-term MV patients in ICUs die during hospitalization.
- Survivors often require extended care facility stays before returning home.
- Open communication about these potential outcomes is vital for patient and family decision-making.