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Tuberculosis & Respiratory Diseases

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Vol.86 No.2
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Association between Participation in a Rehabilitation Program and 1-Year Survival in Patients Requiring Prolonged Mechanical Ventilation

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2023, v.86 no.2, pp.133-141
https://doi.org/10.4046/trd.2022.0137
Kwangha Lee (Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea)
Wanho Yoo (Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine)
Myung Hun Jang (Department of Rehabilitation Medicine, Pusan National University Hospital, Busan)
Sang Hun Kim (Department of Rehabilitation Medicine, Pusan National University Hospital, Busan)
Soohan Kim (Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine,)
Eun-Jung Jo (Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, 3 Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea)
Jung Seop Eom (Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea)
Jeongha Mok (Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea)
Mi-Hyun Kim (Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, 3 Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea)
Kwangha, L. , Wanho, Y. , Myung, H. J. , Sang, H. K. , Soohan, K. , Eun-Jung, J. , Jung, S. E. , Jeongha, M. , & Mi-Hyun, K. (2023). Association between Participation in a Rehabilitation Program and 1-Year Survival in Patients Requiring Prolonged Mechanical Ventilation. Tuberculosis & Respiratory Diseases, 86(2), 133-141, https://doi.org/10.4046/trd.2022.0137
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Abstract

BackgroundThe present study evaluated the association between participation in a rehabilitation program during a hospital stay and 1-year survival of patients requiring at least 21 days of mechanical ventilation (prolonged mechanical ventilation [PMV]) with various respiratory diseases as their main diagnoses that led to mechanical ventilation. MethodsRetrospective data of 105 patients (71.4% male, mean age 70.1±11.3 years) who received PMV in the past 5 years were analyzed. Rehabilitation included physiotherapy, physical rehabilitation, and dysphagia treatment program that was individually provided by physiatrists. ResultsThe main diagnosis leading to mechanical ventilation was pneumonia (n=101, 96.2%) and the 1-year survival rate was 33.3% (n=35). One-year survivors had lower Acute Physiology and Chronic Health Evaluation (APACHE) II score (20.2±5.8 vs. 24.2±7.5, p=0.006) and Sequential Organ Failure Assessment score (6.7±5.6 vs. 8.5±2.7, p=0.001) on the day of intubation than non-survivors. More survivors participated in a rehabilitation program during their hospital stays (88.6% vs. 57.1%, p=0.001). The rehabilitation program was an independent factor for 1-year survival based on the Cox proportional hazard model (hazard ratio, 3.513; 95% confidence interval, 1.785 to 6.930; p<0.001) in patients with APACHE II scores ≤23 (a cutoff value based on Youden’s index). ConclusionOur study showed that participation in a rehabilitation program during hospital stay was associated with an improvement of 1-year survival of PMV patients who had less severe illness on the day of intubation.

keywords
Mechanical Ventilation, Rehabilitation, Intensive Care Unit

Tuberculosis & Respiratory Diseases

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