Tuberc Respir Dis > Epub ahead of print
DOI: https://doi.org/10.4046/trd.2022.0137    [Epub ahead of print]
Published online January 20, 2023.
Association between Participation in a Rehabilitation Program and 1-Year Survival in Patients Requiring Prolonged Mechanical Ventilation
Wanho Yoo, M.D.1  , Myung Hun Jang, M.D.2  , Sang Hun Kim, M.D.2  , Soohan Kim, M.D.1  , Eun-Jung Jo, M.D.1,3  , Jung Seop Eom, M.D.1,3  , Jeongha Mok, M.D.1,3  , Mi-Hyun Kim, M.D.1,3  , Kwangha Lee, M.D., Ph.D.1,3 
1Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
2Department of Rehabilitation Medicine, Pusan National University Hospital, Busan, Republic of Korea
3Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
Correspondence:  Kwangha Lee, Tel: 82-51-240-7743, Fax: 82-51-240-8677, 
Email: jubilate@pusan.ac.kr
Received: 14 November 2022   • Revised: 16 November 2022   • Accepted: 4 January 2023
Abstract
Background
The 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.
Methods
Retrospective 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.
Results
The 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).
Conclusion
Our 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.
Key Words: Mechanical Ventilation, Rehabilitation, Intensive Care Unit


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