Determinants of outcome for patients admitted to a long-term ventilator unit.
BACKGROUND
This prospective cohort study was done to identify determinants of successful weaning from mechanical ventilation among patients admitted to the 10-bed long-term ventilator unit (LTVU) of a teaching hospital.


METHODS
Prospective patient surveillance and data collection were done on 472 patients admitted to the LTVU over a 4-year period (January 1996 to December 1999).


RESULTS
Multiple logistic regression analysis showed that the absence of home mechanical ventilation at the time of hospital admission, absence of intensive care unit (ICU) readmission, and admission to the LTVU from a nonmedical service were independently associated with successful weaning. No statistical difference between hospital survivors and nonsurvivors was associated with length of stay in the LTVU and length of stay in the hospital.


CONCLUSIONS
Patients admitted to an LTVU require prolonged hospitalizations and intensive resource utilization. These data suggest that improved methods for identifying patients who are unlikely to benefit from prolonged mechanical ventilation may assist physicians in their discussions with patients and family members as they consider various treatment options.
Iregui
Manuel
M
Pulmonary and Critical Care Division, Washington University School of Medicine, St. Louis, MO 63110, USA.
Malen
Jill
J
Tuteur
Peter
P
Lynch
John
J
Holtzman
Michael J
MJ
Kollef
Marin H
MH
D000368:Aged; D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality; D006757:Hospital Units / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000401:mortality* / Q000628:therapy*; D012307:Risk Factors; D013997:Time Factors; D015300:Ventilator Weaning / Q000706:statistics & numerical data*