If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  Poor Outcomes Reported for Chronically Critically Ill Patients Leaving Hospitals on Ventilators CLEVELAND, Ohio -- December 3, 2009 -- Patients, discharged from hospitals on ventilator support and with cognitive impairments, fare poorly 4 months later, reported researchers from the Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. These findings were published in the American Journal of Critical Care. “Survival alone is not the only important outcome for patients,” said Barbara Daly, University Hospitals Case Medical Center, the lead researcher on the National Institutes of Health-funded study, “Composite Outcomes of Chronically Critically Ill Patients 4 Months After Hospital Discharge.” She added 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 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 1 week in the intensive care unit and spent more than 3 days on ventilator support. Following 257 patients at 2 and 4 months after their hospital stays, researchers found that 112 (43.6%) had what they categorised as “better” outcomes (living at home, able to breathe independently, with normal cognitive functioning). The 159 patients who were functioning without any cognitive impairment 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 1 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 cognitive functioning, breathing on ventilator, and living in a care facility. Little has been known about what happens after CCI patients leave the hospital, said Daly. “We believe that knowledge of exactly how rare ‘better’ outcomes are for those patients who are cognitively impaired and ventilator dependent at discharge is important information for ICU clinicians who are counselling families about treatment decisions,” wrote 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
|
