Abstract
BACKGROUND:
Epidemiological data on patients with COVID-19 referred to specialized weaning centers (SWCs) are sparse, particularly in low- and middle-income countries. Our aim was to describe clinical features, epidemiology, and outcomes of subjects admitted to SWCs in Argentina.
METHODS:
We conducted a prospective, multi-center, observational study between July 2020–December 2021 in 12 SWCs. We collected demographic characteristics, laboratory results, pulmonary function, and dependence on mechanical ventilation at admission, decannulation, weaning from mechanical ventilation, and status at discharge. A multiple logistic model was built to predict home discharge.
RESULTS:
We enrolled 568 tracheostomized adult subjects after the acute COVID-19 phase who were transferred to SWCs. Age was 62 [52–71], males 70%, Charlson comorbidity index was 2 [0–3], and length of stay in ICU was 42 [32–56] d. Of the 315 ventilator-dependent subjects, 72.4% were weaned, 427 (75.2%) were decannulated, and 366 subjects (64.5%) were discharged home. The mortality rate was 6.0%. In multivariate analysis, age (odds ratio 0.30 [95% CI 0.16–0.56], P < .001), Charlson comorbidity index (odds ratio 0.43 [95% CI 0.22–0.84], P < .01), mechanical ventilation duration in ICU (odds ratio 0.80 [95% CI 0.72–0.89], P < .001), renal failure (odds ratio 0.40 [95% CI 0.22–0.73], P = .003), and expiratory muscle weakness (odds ratio 0.35 [95% CI 0.19–0.62], P < .001) were independently associated with home discharge.
CONCLUSIONS:
Most subjects with COVID-19 transferred to SWCs were weaned, achieved decannulation, and were discharged to home. Age, high-comorbidity burden, prolonged mechanical ventilation in ICU, renal failure at admission, and expiratory muscle weakness were inversely associated with home discharge.
Keywords
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