Geriatric rehabilitation center outcomes after successful weaning from extremely prolonged mechanical ventilation in older adults.

IF 1.5 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Croatian Medical Journal Pub Date : 2024-10-31

Igor Kisil, Yuri Gimelfarb, Arie Soroksky

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引用次数: 0

Abstract

Aim: To determine the rate of and predictive factors for postacute in-hospital survival of older adults after successful weaning from extremely prolonged mechanical ventilation (e-PMV).

Methods: This pilot retrospective study involved patients who were weaned from e-PMV in Bayit Balev Geriatric and Rehabilitation Center, Maccabi Health Services, Bat Yam, Israel between January 2010 and May 2022. In-hospital survival was measured.

Results: Out of 488 patients (of all ages) treated in our geriatric rehabilitation center (GRC) during the study period, only 181 patients aged 65 years and older were conscious and were candidates for weaning from e-PMV. Seventy-three patients (40.3%) were weaned and therefore recruited to this study. Six patients (8.2%) were weaned but died before discharge. Out of the 67 (91.8%) who were alive and weaned, 18 (24.7%) were decanulated and discharged to their homes, and the remaining 49 (75.3%) were weaned and discharged from our GRC with tracheostomy canula to other long-term care institutions. Univariate analysis showed that in-hospital survival was significantly dependent on age and the presence of tracheomalacia, both in a time-independent and time-dependent manner. In a time-dependent (adjusted) multivariate analysis, there were no independent predictive factors for in-hospital mortality.

Conclusions: A dedicated GRC team can wean a substantial number of patients after e-PMV and return them to their community and even homes.

本刊更多论文

老年人成功脱离极度长时间机械通气后的老年康复中心疗效。

目的：确定从超长机械通气（e-PMV）成功断气后的老年人院内急性期存活率和预测因素：这项试点回顾性研究涉及 2010 年 1 月至 2022 年 5 月期间在以色列巴特亚姆马卡比医疗服务机构巴伊特-巴列夫老年病与康复中心（Bayit Balev Geriatric and Rehabilitation Center）完成极度延长机械通气（e-PMV）断奶的患者。结果：研究期间，在我们的老年康复中心（GRC）接受治疗的 488 名患者（不分年龄）中，只有 181 名 65 岁及以上的患者意识清醒，可以断开电子镇静剂。73名患者（40.3%）已经断奶，因此被纳入本研究。六名患者（8.2%）断了奶，但在出院前死亡。在 67 名（91.8%）存活并断奶的患者中，18 名（24.7%）断奶后出院回家，其余 49 名（75.3%）断奶后带着气管造口插管从我们的 GRC 出院到其他长期护理机构。单变量分析表明，院内存活率与年龄和是否存在气管瘘有显著关系，既与时间无关，也与时间有关。在与时间相关（调整后）的多变量分析中，院内死亡率没有独立的预测因素：专门的 GRC 团队可以让大量接受电子胸腔穿刺术的患者脱离呼吸道，重返社区甚至家中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Croatian Medical Journal 医学-医学：内科

CiteScore

3.00

自引率

5.30%

发文量

105

审稿时长

6-12 weeks

期刊介绍： Croatian Medical Journal (CMJ) is an international peer reviewed journal open to scientists from all fields of biomedicine and health related research. Although CMJ welcomes all contributions that increase and expand on medical knowledge, the two areas are of the special interest: topics globally relevant for biomedicine and health and medicine in developing and emerging countries.