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

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.