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

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.