Objective: Predictors of long-term functional impairment in acute respiratory failure of all causes are poorly understood. Our objective was to assess the frequency and predictors of long-term functional impairment or death after invasive mechanical ventilation for acute respiratory failure of all causes. Design: Population-based, observational cohort study. Setting: Eight adult ICUs of a single center. Patients: All adult patients from Olmsted County, Minnesota, without baseline functional impairment who received mechanical ventilation in ICUs for acute respiratory failure of all causes from 2005 through 2009. Interventions: None. Measurements and Main Results: In total, 743 patients without baseline functional impairment received mechanical ventilation in the ICU. At 1- and 5-year follow-up, the rates of survival with return to baseline functional ability were 61% (366/597) and 53% (356/669). Among 71 patients with new functional impairment at 1 year, 55% (39/71) had recovered and were alive without functional impairment at 5 years. Factors predictive of new functional impairment or death at 1 year were age, comorbidities, discharge to other than home, mechanical ventilation of 7 days or longer, and stroke. Of factors known at the time of intubation, the following are predictive of new functional impairment or death: age, comorbidities, nonsurgical condition, Acute Physiology and Chronic Health Evaluation III score, stroke, and sepsis. Post hoc sensitivity analyses revealed no significant change in predictor variables in patient populations when stroke was excluded or who received more than 48 hours of mechanical ventilation. Conclusions: At 1- and 5-year follow-up, many patients who received mechanical ventilation for acute respiratory failure from all causes are no longer alive or have new moderate-to-severe functional impairment. Functional recovery between year 1 and year 5 is possible and common. Sepsis, stroke, illness severity, age, and comorbidities predict long-term functional outcome at intubation. This work was performed at the Mayo Clinic, Rochester, MN. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (http://ift.tt/29S62lw). Supported by the Mayo Clinic Foundation and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic. The funding sources had no role in the design and conduct of the study; collection, management, analysis, or interpretation of the data; and preparation, review, or approval of the article for publication. The authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: wilson.michael1@mayo.edu Copyright © by 2017 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2zcBukQ
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δημοφιλείς αναρτήσεις
-
Champion EMS is currently seeking a Communications Center Manager. Champion EMS is based out of Longview, Texas, serving the East Texas area...
-
from EMS via xlomafota13 on Inoreader http://ift.tt/2sbML2K
-
The name of the second author of this article was incorrectly presented as "Riccardo Scarpa Cosimo" this should have been "Co...
-
Abstract Given shifting sex work criminalization and enforcement in Canada, this study examined worrying about workplace inspections by au...
-
Abstract Introduction In recent years, platelet-rich plasma (PRP) has emerged as a promising autologous biological treatment modality fo...
-
Abstract Background Permissive hypotensive resuscitation (PHR) is an advancing concept aiming towards deliberative balanced resuscitation ...
-
from EMS via xlomafota13 on Inoreader http://ift.tt/2sbML2K
-
While the psychiatric disorders are conditions frequently encountered in hospitalized patients, there are little or no data regarding the ch...
-
No abstract available from Emergency Medicine via xlomafota13 on Inoreader https://ift.tt/2Tlj4K7
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου