Mortality and Readmission Among Ventilator-dependent Patients After Successful Weaned Discharge From a Respiratory Care Ward

Background/PurposePatients on prolonged mechanical ventilation in Taiwan are stepped down to a respiratory care ward (RCW) for further respiratory care. Only a few patients in the RCW can ultimately be weaned and discharged. In this study, we tried to determine factors that predict mortality and readmission of these patients in the post-discharge period.MethodsBetween May 1, 2004 and October 31, 2006, clinical data were retrospectively analyzed for eligible patients in a RCW. Patients who were successfully weaned from mechanical ventilation were enrolled in this study.ResultsA total of 243 patients were eligible for evaluation, and 67 patients were successfully weaned and discharged. By Kaplan-Meier curve, 36 (67.1%) patients were readmitted within 3 months after discharge, and among these, 23 (63.9%) had mechanical ventilation reinstituted at the time of first readmission. The most common cause of readmission was airway infection (80.5%). Overall mortality and readmission rates at 1 year after weaned discharge were 32.9% and 88.2%, respectively. By multivariate analysis, patients with neurologic causes of ventilator dependency were less likely to be readmitted (hazard ratio = 0.36; p =0.034), and neoplastic diseases (hazard ratio = 4.66; p =0.031) were independently associated with mortality.ConclusionUnderlying comorbidities and causes of ventilator dependency are important predictors of mortality and readmission among patients after weaned discharge from a RCW.