RATIONALE: Patients on prolonged mechanical ventilation (PMV) at Long-Term Acute Care Hospital's (LTACHs) are clinically heterogeneous making it difficult to manage care and predict clinical outcomes. OBJECTIVES: Identify and describe subgroups of patients on PMV at LTACHs and examine for group differences. METHODS: Latent class analysis was completed on data obtained during medical record review at Midwestern LTACH. MAIN RESULTS: A three-class solution was identified. Class 1 contained young, obese patients with low clinical and co-morbid burden; Class 2 contained the oldest patients with low clinical burden but multiple co-morbid conditions; Class 3 contained patients with multiple clinical and co-morbid burdens. There were no differences in LTACH length of stay [F(2,246) = 2.243, p = 0.108] or number of ventilator days [F(2,246) = 0.641, p = 0.528]. Class 3 patients were less likely to wean from mechanical ventilation [χ2(2, N = 249) = 25.48, p < 0.001] and more likely to die [χ2(2, N = 249) = 23.68, p < 0.001]. CONCLUSION: Patient subgroups can be described that predict clinical outcomes. Class 3 patients are at higher risk for poor clinical outcomes when compared to patients in Class 1 or Class 2.
RATIONALE: Patients on prolonged mechanical ventilation (PMV) at Long-Term Acute Care Hospital's (LTACHs) are clinically heterogeneous making it difficult to manage care and predict clinical outcomes. OBJECTIVES: Identify and describe subgroups of patients on PMV at LTACHs and examine for group differences. METHODS: Latent class analysis was completed on data obtained during medical record review at Midwestern LTACH. MAIN RESULTS: A three-class solution was identified. Class 1 contained young, obesepatients with low clinical and co-morbid burden; Class 2 contained the oldest patients with low clinical burden but multiple co-morbid conditions; Class 3 contained patients with multiple clinical and co-morbid burdens. There were no differences in LTACH length of stay [F(2,246) = 2.243, p = 0.108] or number of ventilator days [F(2,246) = 0.641, p = 0.528]. Class 3 patients were less likely to wean from mechanical ventilation [χ2(2, N = 249) = 25.48, p < 0.001] and more likely to die [χ2(2, N = 249) = 23.68, p < 0.001]. CONCLUSION:Patient subgroups can be described that predict clinical outcomes. Class 3 patients are at higher risk for poor clinical outcomes when compared to patients in Class 1 or Class 2.
Authors: Paul A Harris; Robert Taylor; Robert Thielke; Jonathon Payne; Nathaniel Gonzalez; Jose G Conde Journal: J Biomed Inform Date: 2008-09-30 Impact factor: 6.317
Authors: Helle Søholm; Jesper Kjaergaard; John Bro-Jeppesen; Jakob Hartvig-Thomsen; Freddy Lippert; Lars Køber; Niklas Nielsen; Magaly Engsig; Morten Steensen; Michael Wanscher; Finn Michael Karlsen; Christian Hassager Journal: Circ Cardiovasc Qual Outcomes Date: 2015-05-05
Authors: S Allen Ensminger; Ian J Morales; Steve G Peters; Mark T Keegan; Javier D Finkielman; James F Lymp; Bekele Afessa Journal: Chest Date: 2004-10 Impact factor: 9.410
Authors: Hans A J M Kuijsten; Sylvia Brinkman; Iwan A Meynaar; Peter E Spronk; Johan I van der Spoel; Rob J Bosman; Nicolette F de Keizer; Ameen Abu-Hanna; Dylan W de Lange Journal: Intensive Care Med Date: 2010-06-15 Impact factor: 17.440
Authors: Christopher E Cox; Shannon S Carson; Joseph A Govert; Lakshmipathi Chelluri; Gillian D Sanders Journal: Crit Care Med Date: 2007-08 Impact factor: 7.598