Background: Respiratory intensive care units (RICU) dedicated to weaning could be suitable facilities for clinical management of “post-ICU” patients Methods: We retrospectively analyzed the time course of patients' characteristics, clinical outcomes and sanitary staff utilization in 5 Italian RICU by comparing 3 periods of 5 consecutive years (from 1991 to 2005). Results: 3,106 patients (age, 76±4 yrs; 72% males) were analyzed. The number of co-morbidities per patient (from 1.8 to 3.0, p=0.05) and the previous intensive care unit stay (from 25 to 32 days, p=0.002) increased over time. The doctor-to-patients ratio significantly decreased over time (from 1:3 to 1:5, p<0.01) while the physiotherapist-to-patients ratio mildly increased (from 1:6 to 1:4.5, p<0.05). The overall weaning success rate decreased (from 87% to 66%, p<0.001) and the discharge destination changed (p<0.001) over time; less patients were discharged to home (from 22% to 10%), and more patients to nursing home (from 3% to 6%), acute hospitals (from 6% to 10%) and rehabilitative units (from 70% to 75%). The mortality rate increased over time (from 9% to 15%). Significant correlations between the doctor-to-patients ratio and the rates of weaning success (r=0.679, p=0.005), home discharge (r=0.722, p=0.002), and the RICU length of stay (LOS) (r=-0.683, p=0.005) were observed.Conclusions: The clinical outcomes of our units worsened over 15 years, likely as consequence of admitting more severely-ill patients. The potential negative influence of reduced medical staff availability on weaning success, home discharge and LOS warrants further prospective investigations.

Patients’ characterization, hospital course and clinical outcomes in five Italian Respiratory Intensive Care Units / E., Polverino; S., Nava; M., Ferrer; P., Ceriana; Clini, Enrico; E., Spada; E., Zanotti; L., Trianni; L., Barbano; C., Fracchia; B., Balbi; M., Vitacca. - In: INTENSIVE CARE MEDICINE. - ISSN 0342-4642. - ELETTRONICO. - 36:(2010), pp. 137-142. [10.1007/s00134-009-1658-2]

Patients’ characterization, hospital course and clinical outcomes in five Italian Respiratory Intensive Care Units

CLINI, Enrico;
2010

Abstract

Background: Respiratory intensive care units (RICU) dedicated to weaning could be suitable facilities for clinical management of “post-ICU” patients Methods: We retrospectively analyzed the time course of patients' characteristics, clinical outcomes and sanitary staff utilization in 5 Italian RICU by comparing 3 periods of 5 consecutive years (from 1991 to 2005). Results: 3,106 patients (age, 76±4 yrs; 72% males) were analyzed. The number of co-morbidities per patient (from 1.8 to 3.0, p=0.05) and the previous intensive care unit stay (from 25 to 32 days, p=0.002) increased over time. The doctor-to-patients ratio significantly decreased over time (from 1:3 to 1:5, p<0.01) while the physiotherapist-to-patients ratio mildly increased (from 1:6 to 1:4.5, p<0.05). The overall weaning success rate decreased (from 87% to 66%, p<0.001) and the discharge destination changed (p<0.001) over time; less patients were discharged to home (from 22% to 10%), and more patients to nursing home (from 3% to 6%), acute hospitals (from 6% to 10%) and rehabilitative units (from 70% to 75%). The mortality rate increased over time (from 9% to 15%). Significant correlations between the doctor-to-patients ratio and the rates of weaning success (r=0.679, p=0.005), home discharge (r=0.722, p=0.002), and the RICU length of stay (LOS) (r=-0.683, p=0.005) were observed.Conclusions: The clinical outcomes of our units worsened over 15 years, likely as consequence of admitting more severely-ill patients. The potential negative influence of reduced medical staff availability on weaning success, home discharge and LOS warrants further prospective investigations.
2010
26-set-2009
36
137
142
Patients’ characterization, hospital course and clinical outcomes in five Italian Respiratory Intensive Care Units / E., Polverino; S., Nava; M., Ferrer; P., Ceriana; Clini, Enrico; E., Spada; E., Zanotti; L., Trianni; L., Barbano; C., Fracchia; B., Balbi; M., Vitacca. - In: INTENSIVE CARE MEDICINE. - ISSN 0342-4642. - ELETTRONICO. - 36:(2010), pp. 137-142. [10.1007/s00134-009-1658-2]
E., Polverino; S., Nava; M., Ferrer; P., Ceriana; Clini, Enrico; E., Spada; E., Zanotti; L., Trianni; L., Barbano; C., Fracchia; B., Balbi; M., Vitacca
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/615415
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