Prolonged mechanical ventilation patient outcome after discharge from an intensive care unit

Abstract

Background: Mechanical ventilation (MV) is one of the pillars of therapy in the Intensive Care Unit (ICU) as many patients require ventilatory support. This study aimed to analyze the outcome of Prolonged Mechanical Ventilation (PMV) patients after discharge from an Intensive Care Unit (ICU). Methods: This is a retrospective cross-sectional study of 142 medical charts of patients admitted to an ICU and a Special Care Unit (SCU) in Brazil from 2012 to 2014. Results: Participants’ mean age was 66.5 and the majority were men (58.5%). Outcome in the ICU was correlated with laparotomies before (p=0.043) and after (p=0.049) admission, sepsis (p=0.013), dialysis-requiring acute kidney injury (AKI) (p<0.001), and hemodynamic instability (p=0.003). Dialysis-requiring AKI (p=0.012), non-dialysis-requiring AKI (p=0.023) and atelectasis (p=0.045) during ICU stay were correlated with death in SCU patients. Only hemodynamic instability (p=0.002) and diarrhea (p=0.045) were correlated with outcome in the SCU. Additionally, 91 (64.1%) PMV patients in the ICU were discharged to the SCU, 50 (35.2%) died, and one (0.7%) was transferred to another hospital. Furthermore, 15 (16.5%) SCU patients were discharged to the Home Care Program and one (1.1%) was transferred to another hospital. Conclusions: PMV patients exhibited longer hospital stay and higher mortality. Dialysis-requiring AKI and hemodynamic instability were associated with increased risk of death. Only a few PMV patients were successfully discharged or referred to Home Care.