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Post-ICU Mechanical Ventilation at Long-Term Care Hospitals:
A Multicenter Outcomes Study
Sponsored by the National Association of Long Term Hospitals (NALTH)
  Project Overview
The National Association of Long Term Hospitals (NALTH) represents the interests of hospitals located throughout the United States caring for patients who are medically complex, requiring prolonged hospitalization and rehabilitation. Patients treated in long-term care hospitals have varying levels of severity of illness - those requiring acute and intensive care interventions, and others necessitating consistent, but less intensive care. These hospitals provide specialized programs, such as ventilator-dependent and respiratory care, weaning from mechanical ventilation, wound care management, and stroke rehabilitation, among other services. Many offer a wide range of rehabilitation services. Licensure varies by state; for example, in some states the license is for acute general care, and in others, for chronic disease.

Long-term hospitals are referral centers for community hospitals and medical centers, receiving small numbers of patients from each of the hospitals in the catchment areas. Long-term care hospitals develop a level of expertise and experience with their specific patient populations difficult to duplicate in community hospitals. As with other centers of excellence, this is because of the volume of patients treated with a specific disease, or diseases.

Patients admitted to long-term acute care (LTAC) hospitals typically have multiple comorbidities, receive more ICU-like interventions, and tend to require prolonged hospitalization, a period of over 25 days. LTAC hospitals are a heterogeneous group that provides a broad range of services, including weaning from prolonged mechanical ventilation (PMV). Those facilities offering this service are often referred to as Regional Weaning Centers (RWC).

Purpose
To describe the population and report selected outcomes of ventilator-dependent patients admitted to NALTH member facilities for attempted weaning from prolonged mechanical ventilation (PMV).

Population
Patients admitted ventilator-dependent (invasive mechanical ventilation) to NALTH member hospitals for attempted weaning from the ventilator. PMV is generally defined as 21 days of mechanical ventilation for at least six (6) hours per day.

Study
Multicenter, prospective, observational quality assurance study of ventilator-dependent patients admitted to NALTH member hospitals over a one-year period. Measurements and results will include, but are not limited to: demographics, severity of illness, diagnoses leading to ventilator dependence, comorbidities, outcomes of weaning attempts, time to wean, length of stay, functional status, disposition, survival and quality of life data, and cost of care.

Patient Enrollment
Projected enrollment: Approximately 2,000 patients
Start date: March 1, 2002

Principal Investigator: David J. Scheinhorn, M.D., FACP, FCCP
Primary Research Site: Barlow Respiratory Hospital
Data Coordination Center: Barlow Respiratory Research Center

Questions to Meg Hassenpflug: mhassenpflug@barlow2000.org