Hospital readmission among long-term ventilator patients.
OBJECTIVE
Patients experiencing prolonged periods of in-hospital mechanical ventilation have been described as long-term ventilator (LTV) patients. The purpose of this study was to document the incidence of hospital readmission and to identify risk factors for readmission for LTV patients up to 6 months after hospital discharge.


METHODS
This study was part of a larger prospective longitudinal descriptive study of posthospital outcomes for LTV patients.


METHODS
One hundred ninety-nine ICU patients admitted to a university medical center, Veterans Administration hospital, or small community hospital who required > 96 h of continuous in-hospital mechanical ventilation were enrolled.


RESULTS
Descriptive statistics, logistic regression, and survival analytic techniques were used. The 6-month hospital readmission rate was 38%. Readmission occurred most often within days 1 to 60 days (mean, 39.2 days) posthospital discharge. Predictive variables for readmission were the following: length of the index hospital stay; length of the index mechanical ventilation; and the need for oxygen at hospital discharge. Using survival analysis, the age category of 66 to 71 years was statistically significant for the relative risk of readmission within the first 30 days of the index hospital discharge.


CONCLUSIONS
LTV patients should be considered at risk for hospital readmission. Further study examining the impact of closer follow-up in the first 60 days posthospital discharge is necessary in order to determine whether there is a more effective way of reducing the risk of readmission for LTV patients.
Douglas
S L
SL
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106-4904, USA. SLD4@po.cwru.edu
Daly
B J
BJ
Brennan
P F
PF
Gordon
N H
NH
Uthis
P
P
D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003422:Critical Care / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008134:Long-Term Care / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012131:Respiratory Insufficiency / Q000453:epidemiology* / Q000628:therapy; D012306:Risk; D015300:Ventilator Weaning / Q000706:statistics & numerical data*