Decker Sérgio R R, Pereira Danielle do A, Rech Gabriela S, Dos Santos Rosa da R M, de Souza Denise, De Carli Raíne F, Trott Geraldine, de Souza Ana P, Gonzaga Janine, Costa Lauren S, Wolf Jonas M, Medeiros Gregory S, Conte Bruna, Madeira Laura C, Biason Livia, Rosa Maria D, Mattioni Mariana F, Muller Isabela T, Bayer Carolia, Filho Odanor F T, Kern Marcelo, Teixeira Cassiano, Carmichael Harris L, Dinglas Victor D, Brown Samuel M, Needham Dale M, Rosa Regis G
Internal Medicine Department, Moinhos de Vento Hospital, Porto Alegre, RS, Brazil.
Division of Cardiovascular Medicine, Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, MA.
Crit Care Explor. 2025 Jun 26;7(7):e1279. doi: 10.1097/CCE.0000000000001279. eCollection 2025 Jul 1.
In-hospital survivorship for acute respiratory failure has improved, but unmet nonmedication healthcare needs may contribute to adverse events post-discharge.
To evaluate the feasibility of characterizing early unmet nonmedication discharge needs, classified as durable medical equipment (DME), home health services (HHS), and follow-up medical appointments (FUA) for acute respiratory failure survivors in Brazil. Secondary objectives include describing the profile of needs, unmet needs, and adverse outcomes post-discharge.
Prospective feasibility cohort study, with enrollment between October 2020 and March 2021.
One tertiary teaching hospital from Southern Brazil with 76 ICU beds.
Adult survivors from acute respiratory failure who were discharged home.
Our primary outcome was the feasibility of measuring unmet nonmedication needs between 7 and 28 days post-discharge, considering greater than 80% of data completeness as feasible. Secondary outcomes included the characterization of needs and needs unmet per type at 1 month and the crude risk of all-cause death, hospital readmission, and urgent visits to the emergency department at 3 months post-discharge.
Of 337 patients screened, 72 were enrolled, and data on unmet nonmedication needs were collected from 66 patients, resulting in a primary feasibility outcome of 91.7%. The median age was 59 years, 38.9% were female, most were self-declared White, and were employed before admission. During the index admission, 87.3% were diagnosed with COVID-19, and 79.2% received invasive mechanical ventilation. The frequency of nonmedication discharge needs was 48 (72.7%) for DME, 54 (81.8%) for HHS, and 60 (90.9%) for FUA. At 1 month, 36 (58.1%) had at least one need unmet; at 3 months, 12 (19.0%) had at least one adverse outcome.
Detailed measurement of nonmedication needs post-discharge for acute respiratory failure survivors in Brazil is feasible. Unmet nonmedication needs are a common problem to be addressed in this population.
急性呼吸衰竭患者的院内生存率有所提高，但未满足的非药物医疗需求可能会导致出院后出现不良事件。
评估对巴西急性呼吸衰竭幸存者出院早期未满足的非药物需求进行特征描述的可行性，这些需求分为耐用医疗设备（DME）、家庭健康服务（HHS）和后续医疗预约（FUA）。次要目标包括描述需求概况、未满足的需求以及出院后的不良结局。
前瞻性可行性队列研究，于2020年10月至2021年3月期间进行入组。
巴西南部一家拥有76张重症监护病床的三级教学医院。
急性呼吸衰竭成年幸存者，出院后回家。
我们主要结局是在出院后7至28天测量未满足的非药物需求的可行性，将数据完整性超过80%视为可行。次要结局包括在1个月时按类型对需求和未满足需求进行特征描述，以及在出院后3个月时全因死亡、再次住院和急诊紧急就诊的粗略风险。
在337名筛查患者中，72名入组，从66名患者中收集了未满足的非药物需求数据，主要可行性结局为91.7%。中位年龄为59岁，38.9%为女性，大多数自称是白人，入院前有工作。在本次住院期间，87.3%被诊断为新冠肺炎，79.2%接受有创机械通气。DME的非药物出院需求频率为48（72.7%），HHS为54（81.8%），FUA为60（90.9%）。在1个月时，36（58.1%）至少有一项需求未得到满足；在3个月时，12（19.0%）至少有一项不良结局。
对巴西急性呼吸衰竭幸存者出院后的非药物需求进行详细测量是可行的。未满足的非药物需求是该人群中一个需要解决的常见问题。
