Critical care explorations · 2025
Unmet Nonmedication Needs After Hospital Discharge and Adverse Outcomes Among Acute Respiratory Failure Survivors in Brazil: A Prospective Feasibility Study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Decker Sérgio R R, Pereira Danielle do A, Rech Gabriela S, Dos Santos Rosa da R M, de Souza Denise, De Carli Raíne F, Trott Geraldine, de Souza Ana P, Gonzaga Janine, Costa Lauren S, Wolf Jonas M, Medeiros Gregory S, Conte Bruna, Madeira Laura C, Biason Livia, Rosa Maria D, Mattioni Mariana F, Muller Isabela T, Bayer Carolia, Filho Odanor F T, Kern Marcelo, Teixeira Cassiano, Carmichael Harris L, Dinglas Victor D, Brown Samuel M, Needham Dale M, Rosa Regis G
Аннотация
IMPORTANCE: In-hospital survivorship for acute respiratory failure has improved, but unmet nonmedication healthcare needs may contribute to adverse events post-discharge.
OBJECTIVES: To evaluate the feasibility of characterizing early unmet nonmedication discharge needs, classified as durable medical equipment (DME), home health services (HHS), and follow-up medical appointments (FUA) for acute respiratory failure survivors in Brazil. Secondary objectives include describing the profile of needs, unmet needs, and adverse outcomes post-discharge.
DESIGN: Prospective feasibility cohort study, with enrollment between October 2020 and March 2021.
SETTING: One tertiary teaching hospital from Southern Brazil with 76 ICU beds.
PARTICIPANTS: Adult survivors from acute respiratory failure who were discharged home.
MAIN OUTCOMES AND MEASURES: Our primary outcome was the feasibility of measuring unmet nonmedication needs between 7 and 28 days post-discharge, considering greater than 80% of data completeness as feasible. Secondary outcomes included the characterization of needs and needs unmet per type at 1 month and the crude risk of all-cause death, hospital readmission, and urgent visits to the emergency department at 3 months post-discharge.
RESULTS: Of 337 patients screened, 72 were enrolled, and data on unmet nonmedication needs were collected from 66 patients, resulting in a primary feasibility outcome of 91.7%. The median age was 59 years, 38.9% were female, most were self-declared White, and were employed before admission. During the index admission, 87.3% were diagnosed with COVID-19, and 79.2% received invasive mechanical ventilation. The frequency of nonmedication discharge needs was 48 (72.7%) for DME, 54 (81.8%) for HHS, and 60 (90.9%) for FUA. At 1 month, 36 (58.1%) had at least one need unmet; at 3 months, 12 (19.0%) had at least one adverse outcome.
CONCLUSIONS AND RELEVANCE: Detailed measurement of nonmedication needs post-discharge for acute respiratory failure survivors in Brazil is feasible. Unmet nonmedication needs are a common problem to be addressed in this population.
OBJECTIVES: To evaluate the feasibility of characterizing early unmet nonmedication discharge needs, classified as durable medical equipment (DME), home health services (HHS), and follow-up medical appointments (FUA) for acute respiratory failure survivors in Brazil. Secondary objectives include describing the profile of needs, unmet needs, and adverse outcomes post-discharge.
DESIGN: Prospective feasibility cohort study, with enrollment between October 2020 and March 2021.
SETTING: One tertiary teaching hospital from Southern Brazil with 76 ICU beds.
PARTICIPANTS: Adult survivors from acute respiratory failure who were discharged home.
MAIN OUTCOMES AND MEASURES: Our primary outcome was the feasibility of measuring unmet nonmedication needs between 7 and 28 days post-discharge, considering greater than 80% of data completeness as feasible. Secondary outcomes included the characterization of needs and needs unmet per type at 1 month and the crude risk of all-cause death, hospital readmission, and urgent visits to the emergency department at 3 months post-discharge.
RESULTS: Of 337 patients screened, 72 were enrolled, and data on unmet nonmedication needs were collected from 66 patients, resulting in a primary feasibility outcome of 91.7%. The median age was 59 years, 38.9% were female, most were self-declared White, and were employed before admission. During the index admission, 87.3% were diagnosed with COVID-19, and 79.2% received invasive mechanical ventilation. The frequency of nonmedication discharge needs was 48 (72.7%) for DME, 54 (81.8%) for HHS, and 60 (90.9%) for FUA. At 1 month, 36 (58.1%) had at least one need unmet; at 3 months, 12 (19.0%) had at least one adverse outcome.
CONCLUSIONS AND RELEVANCE: Detailed measurement of nonmedication needs post-discharge for acute respiratory failure survivors in Brazil is feasible. Unmet nonmedication needs are a common problem to be addressed in this population.