Asunto(s)
Desnutrición , Apoyo Nutricional , Adulto , Humanos , Desnutrición/diagnóstico , Desnutrición/etiología , Desnutrición/terapia , Evaluación Nutricional , Literatura de Revisión como Asunto , Apoyo Nutricional/métodos , Apoyo Nutricional/normas , Guías de Práctica Clínica como Asunto , Enfermedad Crítica/terapiaAsunto(s)
Envejecimiento/psicología , Amnesia/psicología , Memoria , Respeto , Anciano , Emociones , HumanosRESUMEN
Advancing age is associated with increasing risk of activities important for independence, such as driving and living alone. Cognitive impairment is more common with older age; financial resources and social support may dwindle. Risk, cognitive impairment, and decisional capacity each change over time. Transparent decision making and harm reduction help balance risk and safety. When a patient lacks decisional capacity, an option that considers the patient's preferences and shows respect for the person is favored. Vulnerable patients making choices that are high risk, and patients for whom others are making such choices, may require state intervention.
Asunto(s)
Conducción de Automóvil , Disfunción Cognitiva , Vida Independiente , Seguridad , Poblaciones Vulnerables , Anciano , Conducción de Automóvil/legislación & jurisprudencia , Conducción de Automóvil/psicología , Disfunción Cognitiva/fisiopatología , Disfunción Cognitiva/psicología , Función Ejecutiva , Humanos , Vida Independiente/ética , Vida Independiente/psicología , Riesgo , Poblaciones Vulnerables/legislación & jurisprudencia , Poblaciones Vulnerables/psicologíaAsunto(s)
COVID-19 , Infecciones Urinarias , Anciano , Humanos , Pandemias , Estudios Prospectivos , SARS-CoV-2 , Infecciones Urinarias/diagnósticoAsunto(s)
Insuficiencia Cardíaca , Médicos , Relaxina , Confusión , Humanos , Proteínas Recombinantes , VasodilatadoresAsunto(s)
Diabetes Mellitus Tipo 2 , Trastornos Mentales , Estudios de Cohortes , Hospitalización , HumanosAsunto(s)
Desnutrición , Prealbúmina , Pruebas Diagnósticas de Rutina , Humanos , Estado NutricionalAsunto(s)
Demencia/clasificación , Geriatría , Anciano , Enfermedad de Alzheimer/clasificación , Femenino , Humanos , MasculinoRESUMEN
INTRODUCTION: Among survivors of intensive care, many remain dependent on mechanical ventilation and are discharged to long-term chronic ventilator units or to skilled nursing facilities. Few long-term outcome data are available on patients transferred from long-term chronic ventilator units. METHODS: We retrospectively followed subjects discharged from a long-term chronic ventilator unit from 2010-2012. We determined where these subjects went, evaluating whether location of discharge had an effect on mortality. RESULTS: We followed 79 subjects who were 64.9 ± 15.9 y old. Average stay in the long-term chronic ventilator unit was 38.5 ± 20.1 d. Within the first year after discharge, 24 (30.3%) subjects died: 17 in a skilled nursing facility, 7 at home. Of those who survived the first year, 28 had been discharged to a skilled nursing facility and 27 to home. Survivors were younger (62.6 ± 12.4 vs 70.4 ± 13.1 y, P = .03), had shorter intensive care unit lengths of stay (10.4 ± 5.0 vs 16.4 ± 11.5 d, P = .03), and were more likely discharged home from long-term chronic ventilator unit (49.0% vs 29.1%, P = .040). CONCLUSIONS: Subjects discharged from an long-term chronic ventilator unit and were alive at 1 y had shorter stays in the ICU and were more likely to be discharged home. Further attention is warranted to assure the survival of critical care patients once they are discharged from intensive care units.