Galiatsatos Panagis, Friedlander Tracy, Dababneh Dina, Nelson Katie, Kelly Denise, Finucane Thomas, Bellantoni Michelle, Greenough William B
Division of Pulmonary and Critical Care Medicine, Johns Hopkins Medicine, Baltimore, Maryland.
Department of Physical Medicine and Rehabilitation, Johns Hopkins Medicine, Baltimore, Maryland.
Respir Care. 2017 Oct;62(10):1284-1290. doi: 10.4187/respcare.05419. Epub 2017 Jul 18.
Among survivors of intensive care, many remain dependent on mechanical ventilation and are discharged to long-term chronic ventilator units or to skilled nursing facilities. Few long-term outcome data are available on patients transferred from long-term chronic ventilator units.
We retrospectively followed subjects discharged from a long-term chronic ventilator unit from 2010-2012. We determined where these subjects went, evaluating whether location of discharge had an effect on mortality.
We followed 79 subjects who were 64.9 ± 15.9 y old. Average stay in the long-term chronic ventilator unit was 38.5 ± 20.1 d. Within the first year after discharge, 24 (30.3%) subjects died: 17 in a skilled nursing facility, 7 at home. Of those who survived the first year, 28 had been discharged to a skilled nursing facility and 27 to home. Survivors were younger (62.6 ± 12.4 vs 70.4 ± 13.1 y, = .03), had shorter intensive care unit lengths of stay (10.4 ± 5.0 vs 16.4 ± 11.5 d, = .03), and were more likely discharged home from long-term chronic ventilator unit (49.0% vs 29.1%, = .040).
Subjects discharged from an long-term chronic ventilator unit and were alive at 1 y had shorter stays in the ICU and were more likely to be discharged home. Further attention is warranted to assure the survival of critical care patients once they are discharged from intensive care units.
在重症监护幸存者中，许多人仍依赖机械通气，出院后被转至长期慢性呼吸机病房或专业护理机构。关于从长期慢性呼吸机病房转出患者的长期预后数据很少。
我们对2010年至2012年从长期慢性呼吸机病房出院的患者进行了回顾性随访。我们确定了这些患者的去向，评估出院地点是否对死亡率有影响。
我们随访了79名年龄为64.9±15.9岁的患者。在长期慢性呼吸机病房的平均住院时间为38.5±20.1天。出院后的第一年内，24名（30.3%）患者死亡：17名在专业护理机构，7名在家中。在存活超过第一年的患者中，28名被转至专业护理机构，27名回家。存活者更年轻（62.6±12.4岁对70.4±13.1岁，P =.03），重症监护病房住院时间更短（10.4±5.0天对16.4±11.5天，P =.03），并且更有可能从长期慢性呼吸机病房直接回家（49.0%对29.1%，P =.040）。
从长期慢性呼吸机病房出院且存活1年的患者在重症监护病房住院时间更短，且更有可能直接回家。对于重症监护患者出院后的生存情况，需要给予更多关注以确保其存活。
