Journal of the Formosan Medical Association
Volume 109, Issue 6 , Pages 446-455, June 2010

Mortality and Readmission Among Ventilator-dependent Patients After Successful Weaned Discharge From a Respiratory Care Ward

  • Chun Hui

      Affiliations

    • Department of Chest Medicine, Cheng-Ching General Hospital, Taichung, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Chun Hui, Department of Chest Medicine, Cheng-Ching General Hospital, 118 Section 3, Chung-Kang Road, Taichung 407, Taiwan
    • ,
  • Ming-Chih Lin

      Affiliations

    • Department of Pediatric Intensive Care Unit and Division of Pediatric Cardiology, Taichung Veterans General Hospital, Taichung, Taiwan
    • Institute of Preventive Medicine, National Taiwan University, Taipei, Taiwan
    • ,
  • Tu-Chen Liu

      Affiliations

    • Department of Chest Medicine, Cheng-Ching General Hospital, Taichung, Taiwan
    • ,
  • Ren-Guang Wu

      Affiliations

    • Department of Chest Medicine, Cheng-Ching General Hospital, Taichung, Taiwan

Received 16 May 2009; received in revised form 20 August 2009; accepted 24 September 2009.

Article Outline

Background/Purpose

Patients on prolonged mechanical ventilation in Taiwan are stepped down to a respiratory care ward (RCW) for further respiratory care. Only a few patients in the RCW can ultimately be weaned and discharged. In this study, we tried to determine factors that predict mortality and readmission of these patients in the post-discharge period.

Methods

Between May 1, 2004 and October 31, 2006, clinical data were retrospectively analyzed for eligible patients in a RCW. Patients who were successfully weaned from mechanical ventilation were enrolled in this study.

Results

A total of 243 patients were eligible for evaluation, and 67 patients were successfully weaned and discharged. By Kaplan-Meier curve, 36 (67.1%) patients were readmitted within 3 months after discharge, and among these, 23 (63.9%) had mechanical ventilation reinstituted at the time of first readmission. The most common cause of readmission was airway infection (80.5%). Overall mortality and readmission rates at 1 year after weaned discharge were 32.9% and 88.2%, respectively. By multivariate analysis, patients with neurologic causes of ventilator dependency were less likely to be readmitted (hazard ratio = 0.36; p =0.034), and neoplastic diseases (hazard ratio = 4.66; p =0.031) were independently associated with mortality.

Conclusion

Underlying comorbidities and causes of ventilator dependency are important predictors of mortality and readmission among patients after weaned discharge from a RCW.

Key Words:  mortality , prolonged mechanical ventilation , readmission , respiratory care ward , weaning

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PII: S0929-6646(10)60076-9

doi:10.1016/S0929-6646(10)60076-9

Journal of the Formosan Medical Association
Volume 109, Issue 6 , Pages 446-455, June 2010

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