Researchers report poor outcomes for CCI patients leaving hospitals on ventilators

Dec 03, 2009

Patients, discharged from hospitals on ventilator support and with cognitive impairments, fare poorly four months later. Researchers from the Frances Payne Bolton School of Nursing at Case Western Reserve University report these findings in American Journal of Critical Care.

"Survival alone is not the only important outcome for patients," says Barbara Daly, the lead researcher on the National Institutes of Health-funded study, "Composite Outcomes of Chronically Critically Ill Patients 4 Months after Hospital Discharge."

She adds that having a better quality of life by living at home, breathing free from the ventilator and having normal cognitive function are also important factors constituting a positive outcome in the aftermath of a hospital stay.

The researchers studied chronically critically ill (CCI) patients, who are those who have survived a life-threatening illness but remain dependent on the high-technology services of a critical care unit. These patients had stays of longer than one week in the intensive care unit and spent more than three days on ventilator support.

Following 257 patients at two and four months after their hospital stays, researchers found that 112 (43.6%) had what they categorized as "better" outcomes (living at home, able to breathe independently, with normal cognitive functioning). The 159 patients who were functioning without any at the time of hospital discharge had better outcomes, with 111 (69.8%)breathing without the ventilator at home by 4 months.

But the results for the 39 patients who required ventilator support at discharge were less encouraging; only one patient had achieved a "better" outcome. Of the study's 98 patients who had cognitive impairments at discharge, 29 (30%) recovered for a better outcome. A worse outcome is considered losing , breathing on ventilator and living in a care facility.

Little has been known about what happens after CCI patients leave the hospital, says Daly, the nursing school's Gertrude Perkins Olivia Professor of Oncology Nursing and clinical ethics director at University Hospitals Case Medical Center.

"We believe that knowledge of exactly how rare 'better' outcomes are for those who are cognitively impaired and ventilator dependent at discharge is important information for ICU clinicians who are counseling families about treatment decisions," write the researchers.

In a past survey about ICU communications, family members raised concerns about not being informed about the long-term consequences of their family member's illness.

Helping doctors and nurses with information about the quality of life following the discharge, can help the medical professionals in care planning and informing family members about outcomes in the months to come.

Source: Case Western Reserve University (news : web)

Explore further: Italian army to grow medical marijuana

add to favorites email to friend print save as pdf

Related Stories

The breathing lifeline that comes at a price

Jun 03, 2008

The ventilators on an intensive care ward of a hospital offer a vital lifeline to the sickest and most vulnerable patients, providing the oxygen that keeps them alive when they are unable to breathe for themselves.

Diabetics experience more complications following trauma

Jul 16, 2007

Individuals with diabetes appear to spend more days in the intensive care unit, use more ventilator support and have more complications during hospitalization for trauma than non-diabetics, according to a report in the July ...

Heart attack not a death sentence

Jul 18, 2008

Survivors of cardiac arrest who received intensive care can expect long-term quality of life at reasonable expense to the health care system. Research published today in BioMed Central's open access journal Critical Care is the ...

Hospital patients are discharged earlier on busier days

Sep 25, 2008

When a hospital is capacity constrained, the constraint can affect admission and discharge decisions. A new study in the RAND Journal of Economics examined how hospitals' admission and discharge behavior is affected by flu ...

Withdrawal of life support often an imperfect compromise

Oct 07, 2008

Intensive Care Unit (ICU) doctors seeking to balance the complex needs of their patients and the patients' families may make an imperfect compromise, withdrawing life support systems over a prolonged period of time. This ...

FDA OKs silver-coated breathing tube

Nov 08, 2007

The U.S. Food and Drug Administration has approved for marketing a breathing tube coated with silver to be used by patients on ventilators.

Recommended for you

Non-stop PET/CT scan provides accurate images

22 hours ago

Siemens is improving PET/CT imaging and data quality while reducing radiation exposure. The Biograph mCT Flow PET/CT scanner is a new positron emission tomography/computed tomography (PET/CT) system that, ...

Experts: Chopin's heart shows signs of TB

Sep 17, 2014

The preserved heart of composer Frederic Chopin contains signs of tuberculosis and possibly some other lung disease, medical experts said Wednesday.

The argument in favor of doping

Sep 17, 2014

Ahead of Friday's court ruling on whether ASADA's investigation into the Essendon Football Club was lawful, world leader in practical and medical ethics Professor Julian Savulescu, looks at whether there is a role for performance-enhancing ...

User comments : 0