Chronic ventilator dependence in elderly patients.
Long-term ventilator dependence is the need for mechanical ventilation for more than 6 h/d for more than 21 days. Long-term ventilator dependence complicates 9% to 20% of the episodes of mechanical ventilation treated in the intensive care units of acute care hospitals; it is associated with an average mortality rate of 40%. Unlike acute respiratory failure, the risk for which does not increase with age, long-term ventilator dependence falls disproportionately to patients aged 70 years or older. During the past 2 decades, a profusion of care sites for patients with long-term ventilator dependence has evolved, largely as the product of the prospective payment system for health services introduced by the Health Care Financing Administration in 1983. The outcome of long-term ventilator dependence in elderly patients across this health care continuum is addressed.
Kleinhenz
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ME
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, St. Louis University School of Medicine, St. Louis, Missouri 63104, USA.
Lewis
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CY
D000368:Aged; D002908:Chronic Disease; D003365:Costs and Cost Analysis; D006757:Hospital Units; D006801:Humans; D008134:Long-Term Care; D012121:Respiration, Artificial / Q000191:economics; D012131:Respiratory Insufficiency / Q000628:therapy; D015300:Ventilator Weaning