0
Abstract: Poster Presentations |

PREDICTORS OF ABILITY TO WEAN FROM PROLONGED MECHANICAL VENTILATION SIX MONTHS AFTER DISCHARGE FROM A MEDICAL INTENSIVE CARE UNIT FREE TO VIEW

Leslie A. Hoffman, PhD*; JiYeon Choi, MSN; Thomas H. Miller, PhD; Keiko Kobayashi, MSN; Thomas G. Zullo, PhD; Michael P. Donahoe, MD
Author and Funding Information

University of Pittsburgh School of Nursing, Pittsburgh, PA


Chest


Chest. 2005;128(4_MeetingAbstracts):369S. doi:10.1378/chest.128.4_MeetingAbstracts.369S-a
Text Size: A A A
Published online

Abstract

PURPOSE:  To examine predictors of ability to wean from mechanical ventilation (MV), functional ability and health-related quality of life (HRQoL) in patients who required prolonged mechanical ventilation (PMV) (≥ 7 days) six months after Medical Intensive Care Unit (MICU) discharge.

METHODS:  Consenting patients (n=145) completed questionnaires rating their functional ability (Health Assessment Questionnaire [HAQ]) one week before MICU admission (baseline), MICU discharge, 1 and 6 months post discharge and HRQoL (SF-36) at baseline, 1 and 6 months. Proxy responses of family members were used when patients could not respond.

RESULTS:  At 6 months, 60.7% patients were living. Survivors were 55.7% female, 59.8± 16.7 yrs of age and on MV for 23.4± 22.5 days at MICU discharge. Complete sets of questionnaires were obtained from 52% patients for SF-36 and 72% for HAQ. At baseline, no differences were seen in SF-36 or HAQ scores. Patients on MV exhibited a statistically significant interaction between MV and Time (p=.034) with higher HAQ scores (worse functional ability) at 1, but not 6 months. SF-36 physical component scores were lower (worse ratings) at 1 (p=.003), but not 6 months. No significant changes were seen in SF-36 mental component scores. Using logistic regression, cormobidity was identified as a significant predictor of ability to wean from MV following MICU discharge (71.4% cases correctly predicted). Age, gender, APACHE III, baseline HAQ and SF-36 scores were not identified as significant predictors.

CONCLUSION:  PMV survivors rate HRQoL similarly 6 months after MICU discharge, regardless of ability to wean from MV. Those not weaned from MV were more compromised in functional ability at 1, but not 6-months. Cormorbidity was the best predictor of ability to wean following MICU discharge.

CLINICAL IMPLICATIONS:  Inability to wean from PMV does not appear to influence ratings of HRQoL 6 months after MICU discharge. Potential reasons include changes in reference point (expectations) or lack of instrument sensitivity. Cormorbidity significantly influences ability to wean following MICU discharge.

DISCLOSURE:  Leslie Hoffman, None.

Wednesday, November 2, 2005

12:30 PM - 2:00 PM


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543