Survival and outcome of neurosurgical patients requiring ventilatory support after intensive care unit stay.

摘要: OBJECTIVE The aim of this study was to analyze the clinical outcome severely ill neurosurgical patients whose need for artificial life support extended. We sought determine whether these benefit from extended treatment both in expectancy and quality life. Furthermore, we evaluated direct cost treatment. METHODS group comprised a consecutive series 346 poor condition who were discharged intensive care unit but still respiratory support. had various diagnoses treated between 2000 2003 at Department Neurosurgery, Helsinki University Central Hospital. followed by specially formatted questionnaires 6 months 1, 2, 5 years after Their health-related with EuroQol EQ-5D; quality-adjusted (QALY) gained costs QALY calculated. RESULTS median follow-up time years. mortality rate 27% 30 days, 45% 1 year, 59% Of patients, 20% good recovery (Glasgow Outcome Scale [GOS] scores 4 5), 18% severe disability (GOS score 3), none vegetative state 2), dead 1), 3% lost follow-up. survivors, 69% lived home, 22% nursing 2% hospital, 7% EQ-5D index value lower than general population: 0.71 (25th percentile [Q1] 0.38 75th [Q3] 0.85) versus 0.85 (Q1 0.73 Q3 1.00). per patient 15,000 euros percentile, 10,000 22,000 euros). Surviving mean 17 +/- 13 QALYs. 2521 euros. CONCLUSION Prolonged step-down critically seems be clinically justified. Moreover, reasonably low.