A historical cohort study on predictors for successful weaning from prolonged mechanical ventilation and up to 3-year survival follow-up in a rehabilitation center

Mila Fradkin, Maya Elyashiv, Amasha Camel, Nirit Agay, Michael Brik, Pierre Singer, Rachel Dankner*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: We followed prolonged mechanically ventilated (PMV) patients for weaning attempts and explored factors associated with successful weaning and long-term survival. Methods: This historical cohort study included all adult PMV patients admitted to a single rehabilitation hospital during 2015–2018 and followed for survival according to weaning success up to 3 years or the end of 2021. Results: The study included 223 PMV patients. Of them, 124 (55.6 %) underwent weaning attempts, with 69 (55.6 %) successfully weaned, 55 (44.4 %) unsuccessfully weaned, and 99 patients with no weaning attempts. The mean age was 67 ± 20 years, with 39 % female patients. Age, sex distributions and albumin levels at admission were not significantly different among the groups. The successful weaning group had a 6 % higher proportion of conscious patients than the failed weaning group (55 % vs. 49 %, respectively, p = 0.45). Patients successfully weaned were less frequently treated with antibiotics for 5 days or more than those unsuccessfully weaned (74 % vs 80 %, respectively, p = 0.07). They also had a lower proportion of time from intubation to tracheostomy greater than 14 days (45 % vs 66 %, p = 0.02). The age, sex, antibiotic treatment, time to tracheostomy exceeding 14 days and time from admission to first weaning attempt adjusted one-year mortality risk of successful vs. failed weaning was somewhat lower, HR = 0.75, 95%CI: 0.33–1.60, p = 0.45, with the same trend by the end of 3 years, HR = 0.77, 95%CI: 0.42–1.39, p = 0.38. Conclusion: Successful weaning from PMV may be associated with better survival and allows chronically ventilated patients to become independent on a ventilator. A larger study is needed to further validate our findings.

Original languageEnglish
Article number107636
JournalRespiratory Medicine
Volume227
DOIs
StatePublished - Jun 2024

Keywords

  • Cohort
  • Long-term mortality
  • Prolonged mechanical ventilation
  • Weaning

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