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Original Research: Chronic Critical IllnessPost-ICU Mechanical Ventilation at 23 Long-term Care Hospitals: A Multicenter Outcomes Study
Section snippets
Materials and Methods
A detailed description of the Ventilation Outcomes Study regarding facility recruitment, investigator training, investigational review board (IRB) approval, and data collection and submission processes has been published.4Briefly, a series of surveys of NALTH-member hospitals yielded 23 sites for study participation. The study design was an observational, quality assurance study, with concurrent data collection. Consecutive adult patients receiving invasive mechanical ventilation admitted to
Results
Between March 1, 2002, and February 28, 2003, 23 LTCHs with weaning programs admitted 1,587 ventilator-dependent patients, enrolling 1,419 patients after 168 exclusions. Characteristics and status of enrolled patients on LTCH admission are shown inTable 1.
Discharge data sets were submitted for 1,414 of 1,419 patients (99.6%) enrolled. The frequency of selected procedures, services, and treatments received by patients during the LTCH stay are listed inTable 2. All patients received multiple
Discussion
Ours is the first multicenter study to report weaning outcomes of ventilator-dependent survivors of catastrophic illness transferred to the post-ICU setting of LTCHs. In this continuum of critical care medicine, more than half of the patients were discharged weaned from mechanical ventilation. Strengths of the current study are that consecutive patients receiving mechanical ventilation were enrolled from 23 different LTCHs, employing uniform definitions of weaning outcomes. More than 30
Expert Panel
David C. Chao, MD, Oak Bend Medical Center, Richmond, TX; Gordon S. Doig, PhD, Institute for International Health, University of Sydney, Sydney, Australia; Scott K. Epstein, MD, Department of Medicine, Tufts University School of Medicine, Boston, MA; E. Bert Knight, MD, Spartanburg Hospital for Restorative Care, Spartanburg, SC; Richard A. Petrak, MD, RML Specialty Hospital, Hinsdale, IL; Ellen A. Pitt, MD; David J. Scheinhorn, MD, Barlow Respiratory Hospital and Research Center, Los Angeles,
Acknowledgments
We thank Karen Slovin, BA, for Web site design and database services. We also thank M. Jillisa Steckart, MEd, PsyD, for analysis and interpretation of selected data in this study.
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This work was performed at Barlow Respiratory Hospital and Research Center, Los Angeles, CA. This study was supported in part by the NALTH and the Norris Foundation. The authors have no conflicts of interest to disclose.
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For the Ventilation Outcomes Study Group. A list of participants is given in the Appendix.