Characteristics and Outcome for Very Elderly Patients (≥ 80 years) Admitted to a Respiratory Care Center in Taiwan

Abstract

Background: The aim of the study was to assess the characteristics of and outcomes for very elderly patients (≥ 80 years) with prolonged mechanical ventilation (PMV) under the mandatory integrated delivery system (IDS) in Taiwan. Method: This was a retrospective observational study conducted in a step-down respiratory care center (RCC) among adult patients aged > 45 years on prolonged mechanical ventilation (≥ 21 days) between January 2006 and December 2008. Results: A total of 288 patients (63 aged 45–65 years, 115 aged 66–79 years, and 110 aged ≥ 80 years) were included in the study. There were more female patients in the oldest group (p<0.01). A cardiovascular disorder as the main reason for ventilator dependence was associated with increasing age (p<0.01). A longer RCC stay in the oldest compared to the youngest group was noted (30 vs 25 days, p=0.02). Some 126 patients (43.8%) were weaned; there was a trend for successful weaning in relation to age group (p=0.04). However, RCC mortality was not associated with age (p=0.44). For weaned patients, those in the oldest group had higher mortality in long-term follow-up (p=0.03). For patients with weaning failure, age had no influence on long-term weaning outcome or mortality rate (p=0.56 and 0.69, respectively). Conclusion: The oldest PMV patients (≥ 80 years) had lower weaning probability and a poorer outcome even if they were weaned from the ventilator in the RCC. For patients with weaning failure, age had no impact on weaning outcome and long-term survival rate after they were transferred to a step-down care facility.

Keywords

• respiratory care center
• weaning