Mechanically assisted ventilation in a community hospital. Immediate outcome, hospital charges, and follow-up of patients

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Abstract
In 100 consecutive patients undergoing mechanically assisted ventilation, immediate survival, hospitalization charges and subsequent 1 yr outcome were prospectively determined. Sixty perent of the patients survived the episode of assisted ventilation. This survival decreased to 50% at the time of hospital discharge and to 33% 1 yr after hospitalization. There were no posthospitalization deaths in patients less than age 50 yr. In those patients older than 70 yr, 51% were dead by the time of hospital discharge and 73% died by 1 yr following discharge. Comparison of features that reflect the magnitude of intensive respiratory care, such as hours of ventilation and intensive care unit (ICU) length of stay, disclosed no statistically significant differences between survivors and nonsurvivors at discharge. Hospitalization charges averaged $10,968/patient. The total charge for respiratory therapy services (including arterial blood gas determinations) averaged $2200. Respiratory care service charges were only marginally different between survivors and nonsurvivors. By contrast, total charges and total length of stay were greater for the survivors. Resource use in the intensive care setting as reflected by hours of mechanical ventilation and ICU length of stay was similar in both survivors and nonsurvivors, with the larger total cost for survivors relating primarily to care outside the ICU. It was confirmed that prognosis is excellent in patients less than 50 yr of age who survive mechanically assisted ventilation for acute respiratory failure and that extubation in elderly patients is not necessarily indicative of a good prognosis.

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