Epidemiology of Tracheostomized Adult Patients Admitted to Specialized Weaning Centers After Acute COVID-19.

COVID-19 SARS-CoV-2 critical illness prolonged mechanical ventilation specialized weaning centers tracheostomy

Journal

Respiratory care
ISSN: 1943-3654
Titre abrégé: Respir Care
Pays: United States
ID NLM: 7510357

Informations de publication

Date de publication:
14 Nov 2023
Historique:
medline: 15 11 2023
pubmed: 15 11 2023
entrez: 14 11 2023
Statut: aheadofprint

Résumé

Epidemiological data on patients with COVID-19 referred to specialized weaning centers (SWCs) are sparse, particularly in low- and middle-income countries. Our aim was to describe clinical features, epidemiology, and outcomes of subjects admitted to SWCs in Argentina. We conducted a prospective, multi-center, observational study between July 2020-December 2021 in 12 SWCs. We collected demographic characteristics, laboratory results, pulmonary function, and dependence on mechanical ventilation at admission, decannulation, weaning from mechanical ventilation, and status at discharge. A multiple logistic model was built to predict home discharge. We enrolled 568 tracheostomized adult subjects after the acute COVID-19 phase who were transferred to SWCs. Age was 62 [52-71], males 70%, Charlson comorbidity index was 2 [0-3], and length of stay in ICU was 42 [32-56] d. Of the 315 ventilator-dependent subjects, 72.4% were weaned, 427 (75.2%) were decannulated, and 366 subjects (64.5%) were discharged home. The mortality rate was 6.0%. In multivariate analysis, age (odds ratio 0.30 [95% CI 0.16-0.56], Most subjects with COVID-19 transferred to SWCs were weaned, achieved decannulation, and were discharged to home. Age, high-comorbidity burden, prolonged mechanical ventilation in ICU, renal failure at admission, and expiratory muscle weakness were inversely associated with home discharge.

Sections du résumé

BACKGROUND BACKGROUND
Epidemiological data on patients with COVID-19 referred to specialized weaning centers (SWCs) are sparse, particularly in low- and middle-income countries. Our aim was to describe clinical features, epidemiology, and outcomes of subjects admitted to SWCs in Argentina.
METHODS METHODS
We conducted a prospective, multi-center, observational study between July 2020-December 2021 in 12 SWCs. We collected demographic characteristics, laboratory results, pulmonary function, and dependence on mechanical ventilation at admission, decannulation, weaning from mechanical ventilation, and status at discharge. A multiple logistic model was built to predict home discharge.
RESULTS RESULTS
We enrolled 568 tracheostomized adult subjects after the acute COVID-19 phase who were transferred to SWCs. Age was 62 [52-71], males 70%, Charlson comorbidity index was 2 [0-3], and length of stay in ICU was 42 [32-56] d. Of the 315 ventilator-dependent subjects, 72.4% were weaned, 427 (75.2%) were decannulated, and 366 subjects (64.5%) were discharged home. The mortality rate was 6.0%. In multivariate analysis, age (odds ratio 0.30 [95% CI 0.16-0.56],
CONCLUSIONS CONCLUSIONS
Most subjects with COVID-19 transferred to SWCs were weaned, achieved decannulation, and were discharged to home. Age, high-comorbidity burden, prolonged mechanical ventilation in ICU, renal failure at admission, and expiratory muscle weakness were inversely associated with home discharge.

Identifiants

pubmed: 37963609
pii: respcare.11113
doi: 10.4187/respcare.11113
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 by Daedalus Enterprises.

Auteurs

Dario Villalba (D)

Clínica Basilea, Ciudad Autónoma de Buenos Aires, Argentina. dariovillalba79@gmail.com.

Emiliano Navarro (E)

Centro del Parque, Ciudad Autónoma de Buenos Aires, Argentina.

Amelia Matesa (A)

Clínica Basilea, Ciudad Autónoma de Buenos Aires, Argentina.

Andrés Brusco (A)

AlCla/Clínica de Rehabilitación Integral, Ciudad Autónoma de Buenos Aires, Argentina.

Virginia Morales (V)

AlCla/Clínica de Rehabilitación Integral, Ciudad Autónoma de Buenos Aires, Argentina.

Gastón Germán Morel Vulliez (GG)

Centro del Parque, Ciudad Autónoma de Buenos Aires, Argentina.

Emilio Sebastián Rositi (ES)

Centro del Parque, Ciudad Autónoma de Buenos Aires, Argentina.

Luciana Prieto (L)

Santa Catalina, Ciudad Autónoma de Buenos Aires, Argentina.

Mauro Javier Bosso (MJ)

Santa Catalina, Ciudad Autónoma de Buenos Aires, Argentina.

Silvana De Paoli (S)

CIAREC, Ciudad Autónoma de Buenos Aires, Argentina.

Alejo Cotero (A)

CIAREC, Ciudad Autónoma de Buenos Aires, Argentina.

Juan Nadur (J)

CIAREC, Ciudad Autónoma de Buenos Aires, Argentina.

Marcela Santini (M)

Clínica Pasteur, Provincia de Neuquén, Argentina.

Marcelo Alonso (M)

Clínica Pasteur, Provincia de Neuquén, Argentina.

Florencia Larocca (F)

Santa Catalina, Ciudad Autónoma de Buenos Aires, Argentina.

Carlos Duarte (C)

Ulme, Ciudad Autónoma de Buenos Aires, Argentina.

Verónica García (V)

Ulme, Ciudad Autónoma de Buenos Aires, Argentina.

Romina Campodónico (R)

Ulme, Ciudad Autónoma de Buenos Aires, Argentina.

Gabriel Musso (G)

Centro Integral de Rehabilitación APREPA, Provincia de Santa Fé, Argentina.

Mariel Leingruber (M)

Centro Integral de Rehabilitación APREPA, Provincia de Santa Fé, Argentina.

Aldana Soledad Morales (AS)

Centro Médico Amenábar, Ciudad Autónoma de Buenos Aires, Argentina.

Analía Segura (A)

CAICE, Provincia de Entre Ríos, Argentina.

María Eugenia Vallory (ME)

CAICE, Provincia de Entre Ríos, Argentina.

Selva Del Carmen Pieruzzi (S)

SEMED, Ciudad Autónoma de Buenos Aires, Argentina.

Pablo Sebastián Pascal (PS)

SEMED, Ciudad Autónoma de Buenos Aires, Argentina.

Eduardo Luis De Vito (EL)

Centro del Parque, Ciudad Autónoma de Buenos Aires, Argentina.

Classifications MeSH