Mechanically ventilated patients in internal medicine wards: Survival and outcome one-year post-discharge

Bathish Jlal, M. Mahmud, B. Galina, Zeidman Aliza
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Abstract

Mechanical ventilation in internal medicine wards is challenging. Weaning the patients from mechanical ventilation (MV) is an even bigger challenge. The aim of this study was to characterize the mechanically ventilated patient`s population in an internal medicine ward, their weaning rate, and one-year mortality and survival rate. Methods : The study was designed as a retrospective study. We collected and analyzed data on MV patients that were hospitalized during 2016-2017 in Internal Medicine Department B, Hasharon Hospital, Rabin Medical Center, Israel. The data was analyzed according to age, gender, ethnicity, background diseases, functional status at admission, marital status and residence of the patient (home or nursing facility). We followed the patients for one year after first admission and analyzed survival and mortality rate, weaning rate, readmission, and reintubation rates. Results : Data were collected from 200 computerized patient records who were ventilated and admitted to Internal Medicine Department B during 2016-2017. A significant statistical relationship was found between the age of the patients (over 75 years) and mortality after one year. There was also a significant statistical relationship between the patient's independence and residence (home or nursing facility) for the first year after intubation. Only 6% of the elderly non-ambulatory patients who came from nursing homes survived one year after discharge. No relationship was found between the patient's gender, ethnicity or marital status for survival or mortality after one year. There was also no relationship between where the intubation took place (home/hospital/ward) and survival or mortality. Conclusions : Older MV patients coming from nursing homes and in need of nursing care had the lowest survival rates. When discussing intubation with the patient, family, medical and nursing staff and interns, these factors should be presented along with an in-depth discussion and awareness of the dying patient law.
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内科病房机械通气患者:出院后1年生存率和转归
内科病房机械通气具有一定的挑战性。让病人脱离机械通气(MV)是一个更大的挑战。本研究的目的是表征内科病房机械通气患者的人群,他们的脱机率,一年死亡率和生存率。方法:采用回顾性研究。我们收集并分析了2016-2017年在以色列Rabin医疗中心Hasharon医院B内科住院的MV患者的数据。根据患者的年龄、性别、种族、疾病背景、入院时的功能状况、婚姻状况和住所(家庭或护理机构)对数据进行分析。我们在首次入院后对患者进行了一年的随访,并分析了生存率、死亡率、脱机率、再入院率和再插管率。结果:收集2016-2017年内科B科200例换气住院的计算机病历资料。患者年龄(75岁以上)与1年后死亡率之间存在显著的统计学关系。在插管后的第一年,患者的独立性和居住(家庭或护理机构)之间也有显著的统计关系。只有6%来自养老院的老年非门诊患者在出院后一年内存活。一年后,患者的性别、种族或婚姻状况与生存率和死亡率没有关系。插管地点(家庭/医院/病房)与存活或死亡率之间也没有关系。结论:来自养老院且需要护理的老年MV患者生存率最低。当与病人、家属、医护人员和实习生讨论插管时,这些因素应与深入讨论和了解临终病人法一起提出。
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