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Of the 334 hospital survivors, only 191 patients (57%) were completely liberated from mechanical ventilation. Survivors were younger and more rehabilitated on discharge. Whether patients were more rehabilitated because they had longer hospital stays or whether they had longer hospital stays because their physicians saw continued progress in walking, eating, and being liberated cannot be determined from this study and is an area for future research Viagra Online.
Of the 191 liberated patients, only 57 patients (30%) had their tracheostomy tubes decannulated before discharge. Again, the better outcome was associated with longer stays, higher costs, and a higher functional recovery on discharge; that is, they could walk and eat. Patients discharged without tracheostomy tubes also had the best 1-year survival (92%).
We found that functional status the ability to eat and walk was an important association with better outcome. This is similar to other studies that found that the inability to walk predicts 30-day mortality in pneumonia and heart failure patients and 6-month mortality in survivors of prolonged mechanical ventilation.
Posthospital survival was predominantly related to ventilator status. Admission creatinine, coronary artery disease, closed head injury, and marital status were also significantly associated with death. Patients who were completely ventilator dependent on hospital discharge had a fourfold increased risk of death. Being partially ventilator dependent or being liberated from mechanical ventilation but still retaining the tracheostomy tube placed patients at a lesser but still elevated risk of death. We found that an elevated admission creatinine is predictive of late mortality. While a similar effect has been found in patients undergoing percutaneous coronary interventions and in postmenopausal women with coronary heart disease Cialis Super Active Canada, a large population-based study found that while renal insufficiency on hospital admission was associated with an increased mortality after discharge, it could be attributed to the factors that cause renal dysfunction, such as diabetes mellitus and hypertension. However, our result was independent of the presence of diabetes mellitus and hypertension.