Prolonged mechanical ventilation in Alberta: A 10 year historical cohort study

Abstract

INTRODUCTION Patients requiring Prolonged Mechanical Ventilation (PMV) are a small but important subset of critically ill patients treated in an Intensive Care Unit (ICU). The purpose of this study is to identify and characterize the PMV population in Alberta, Canada over a period of 10 years and to determine mortality, discharge disposition and healthcare cost. METHODS A search of the Alberta Health Services Enterprise Data Warehouse was performed to characterize all patients with 7 days or more of mechanical ventilation in an acute care hospital in Alberta from 2009-2019. Data linkages were performed to identify survival up to 2 years and Healthcare cost was estimated using resource intensity weight (RIW) score. RESULTS The search identified 11,739 patients ventilated for ≥7 days from 2009-2019. In this cohort, 59% of patients were ventilated for 7-13 days, 20% for 14-20 days and 21% for 21 days or more. The in-hospital survival rate was 68% and the one-year survival from initiation of ventilation was 61%. Of the patients discharged alive, 93% were discharged to community and 7% were discharged to a continuing care center. The median healthcare cost for index hospital admission was $119,627 ($70,549-$200,036) CONCLUSION PMV users require a significant duration of mechanical ventilation, a prolonged stay in the ICU and hospital and high healthcare resource utilization. The majority of these patients survive their index admission and are discharged to community.