Survival and quality of life: Short-term versus long-term ventilator patients
Survival and quality of life: Short-term versus long-term ventilator patients
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DOI：
10.1097/00003246-200212000-00008
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发表时间：
2002-12-01
影响因子：
8.8
通讯作者：
Brennan, PF
中科院分区：
文献类型：
--
作者：
Douglas, SL;Daly, BJ;Brennan, PF
目的：检查出院后死亡率、生活质量和短期护理费用设计：前瞻性纵向描述性研究。设置：出院后在家庭、疗养院和康复中心进行随访。患者：从1997年2月至1999年3月，入组了需要>24小时持续住院机械通气的重症监护室患者。出院后随访患者1年postdischarge.Interventions：无。测量和结果：共538例患者进行了研究。住院死亡率为47.4%，1年死亡率为64.7%;生存分析显示，短期和长期呼吸机患者随时间的生存风险差异无统计学意义。长期患者更有可能出院到疗养院（45.2%）。短期使用呼吸机的患者在出院后的所有时间点都有更好的整体生活质量。收费产生一个长期的幸存者显着高于短期患者，平均86,360美元以上的收费需要产生一个长期的呼吸机患者幸存者1年postdischarge.Conclusions：有短期和长期的呼吸机患者之间没有显着的人口统计学或临床差异。我们的研究结果表明，需要在扩展护理机构继续护理数月的可能性和出院后第一年的死亡风险是该人群的共同特征，需要纳入与患者及其家属的治疗方案讨论中。
Objective: Examine postdischarge mortality, quality of life, and charges for care for short-term (>24 and less than or equal to96 hrs of ventilation) and long-term (>96 hrs) ventilator patients.Design: Prospective longitudinal descriptive study.Setting: Posthospital discharge follow-up in homes, nursing homes, and rehabilitation centers.Patients: Intensive care unit patients who required >24 hrs of continuous in-hospital mechanical ventilation were enrolled from February 1997 through March 1999. Patients living to hospital discharge were followed for 1 yr postdischarge.Interventions: None.Measurements and Results: A total of 538 patients were studied. In-hospital mortality was 47.4%, with a 1-yr mortality rate of 64.7%; survival analysis showed that the different survival risks for short-term and long-term ventilator patients over time were not statistically significant. Long-term patients were more likely to be discharged to a nursing home (45.2%). Short-term ventilator patients had better overall quality of life at all points postdischarge. Charges to produce a long-term survivor were significantly higher than for short-term patients; on average $86,360 more charges were required to produce a long-term ventilator patient survivor for 1 yr postdischarge.Conclusions: There were no significant demographic or clinical differences between short-term and long-term ventilator patients. Our results suggest that the likelihood of need for continued care in an extended-care facility for months and the risk of death during the first year postdischarge are sufficiently common features of this population and need to be included in discussions of treatment options with patients and their families.