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Research ArticleOriginal Contributions

Demographics and Clinical Outcomes of Patients Admitted to a Respiratory Intensive Care Unit Located in a Rehabilitation Center

Piero Ceriana, Monica Delmastro, Ciro Rampulla and Stefano Nava
Respiratory Care July 2003, 48 (7) 670-676;
Piero Ceriana
Respiratory Intensive Care Unit, Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Salvatore Maugeri, Centro Medico di Pavia, Pavia, Italy
MD
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  • For correspondence: [email protected]
Monica Delmastro
Respiratory Intensive Care Unit, Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Salvatore Maugeri, Centro Medico di Pavia, Pavia, Italy
MD
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Ciro Rampulla
Respiratory Intensive Care Unit, Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Salvatore Maugeri, Centro Medico di Pavia, Pavia, Italy
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Stefano Nava
Respiratory Intensive Care Unit, Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Salvatore Maugeri, Centro Medico di Pavia, Pavia, Italy
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Abstract

INTRODUCTION: A recent survey of respiratory intensive care units (RICU) in Italy showed that RICUs in Italy are mainly (85%) located in acute care hospitals. Forty-seven percent of the patients are admitted from emergency departments, and only 18% are admitted from intensive care units (ICU), so the percentage of patients admitted for difficulty in weaning is low (8%). Patient demographics and admission patterns in RICUs located outside acute care hospitals have not been previously described.

METHODS: We analyzed admission patterns, demographics, treatment, and outcomes of patients during the first year of operation of a 7-bed RICU located in a rehabilitation center that does not have an emergency department.

RESULTS: In the 1-year study period, 96 RICU patients were admitted for acute or chronic respiratory failure. The patients' mean Simplified Acute Physiology Score II was 28.9 ± 3.6. Sixty-five percent of the patients were transferred from the ICU, 17% from medical wards of other hospitals, 7% and 5%, respectively, from the medical and surgical wards of our hospital, and 6% came directly from home for a periodic check. Difficulty in weaning from mechanical ventilation was the main reason for admission (42%), followed by simple monitoring (37%) and need for acute ventilatory invasive or noninvasive support (21%). Thirty-one patients had COPD, 23 had acute hypoxemic respiratory failure, 30 had post-surgical complications, and 12 had neuromuscular disease. Twenty-seven of 40 patients admitted for difficulty in weaning were liberated from ventilation. Intrahospital mortality was 13%. Fifty percent of patients were discharged directly to home; those patients' mean Dependence Nursing Scale score (which measures the degree of patient independence) improved during hospital stay (decreased from 23 to 12 [p < 0.05]), whereas the remaining patients were transferred to long-term facilities or an acute care hospital.

CONCLUSIONS: The admission pattern at our RICU in a rehabilitation center is quite different from that of an RICU in an acute care hospital. Most of our patients are admitted from ICU because of difficulty with weaning. This may be the consequence of the institutional philosophy of rehabilitation centers, which strive to achieve greater patient independence.

  • respiratory
  • intensive care unit
  • weaning
  • rehabilitation

Footnotes

  • Correspondence: Piero Ceriana MD, Viale Ludovico il Moro 33, 27100 Pavia, Italy. E-mail: pceriana{at}fsm.it.
  • Copyright © 2003 by Daedalus Enterprises Inc.
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Respiratory Care: 48 (7)
Respiratory Care
Vol. 48, Issue 7
1 Jul 2003
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Demographics and Clinical Outcomes of Patients Admitted to a Respiratory Intensive Care Unit Located in a Rehabilitation Center
Piero Ceriana, Monica Delmastro, Ciro Rampulla, Stefano Nava
Respiratory Care Jul 2003, 48 (7) 670-676;

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Demographics and Clinical Outcomes of Patients Admitted to a Respiratory Intensive Care Unit Located in a Rehabilitation Center
Piero Ceriana, Monica Delmastro, Ciro Rampulla, Stefano Nava
Respiratory Care Jul 2003, 48 (7) 670-676;
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