Long-term outcomes of community-based intensive care treatment following neurological early rehabilitation– results of a multicentric German study
Abstract Background Weaning from mechanical ventilation (MV) and tracheal cannula (TC) during neurological early rehabilitation (NER) is mostly successful. However, some patients leave NER with TC/MV, requiring home-based specialized intensive care nursing (HSICN). Data on medical and demographic ch...
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2025-05-01
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| author | Bernadette Einhäupl Danae Götze Stephanie Reichl Lina Willacker Romy Pletz Thomas Kohlmann Esther Henning Lena Schmeyers Andreas Straube Rebekka Süss Steffen Fleßa Simone Schmidt Jens D. Rollnik Friedemann Müller Aukje Bartsch-de Jong Svenja Blömeke Jennifer Hartl Nuria Vallejo Daniel Liedert Thomas Olander Volker Ziegler Renate Weinhardt Felix Schlachetzki Tatjana Groß Susanne Hirmer Lea Dillbaner Lisa Kleinlein Thomas Platz Andreas Bender |
| author_facet | Bernadette Einhäupl Danae Götze Stephanie Reichl Lina Willacker Romy Pletz Thomas Kohlmann Esther Henning Lena Schmeyers Andreas Straube Rebekka Süss Steffen Fleßa Simone Schmidt Jens D. Rollnik Friedemann Müller Aukje Bartsch-de Jong Svenja Blömeke Jennifer Hartl Nuria Vallejo Daniel Liedert Thomas Olander Volker Ziegler Renate Weinhardt Felix Schlachetzki Tatjana Groß Susanne Hirmer Lea Dillbaner Lisa Kleinlein Thomas Platz Andreas Bender |
| author_sort | Bernadette Einhäupl |
| collection | DOAJ |
| description | Abstract Background Weaning from mechanical ventilation (MV) and tracheal cannula (TC) during neurological early rehabilitation (NER) is mostly successful. However, some patients leave NER with TC/MV, requiring home-based specialized intensive care nursing (HSICN). Data on medical and demographic characteristics and long-term outcomes of these patients are limited. Methods A multicentric retrospective observational study across five German NER hospitals collected data from neurological patients with TC/MV at discharge. The study aimed to assess patients’ health status at NER discharge, and to identify predictors of post-discharge survival. Survival rates were analyzed using Kaplan-Meier estimates; further predictors of survival post-discharge were analyzed using Cox regression. Results Among 312 patients, the one-year survival rate was 61.9%, decreasing to 38.1% after approximately 4 years. Older age, higher overall morbidity and discharge with MV were associated with an increased likelihood of death, while a longer stay in NER correlated with survival. Conclusions Patients requiring HSICN after discharge from NER have a high mortality rate. Identifying survival predictors may help to identify patients at risk, and thus could be integrated into the decision-making process for NER discharge. The high mortality post-discharge warrants an evaluation of the current post-hospital care model. Optimizing therapeutic care in the HSICN setting may have the potential to reduce mortality and neuro-disability, and enhance the quality of life in these neurologically severely affected patients. Trial registration The trial OptiNIV - Retrospective study of post-hospital intensive care in neurological patients has been retrospectively registered in the German Clinical Trials Register (DRKS) since 28.10.2022 with the ID DRKS00030580. |
| format | Article |
| id | doaj-art-b1cbacb842e548c7b13f4430ab2fa503 |
| institution | OA Journals |
| issn | 2524-3489 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | Neurological Research and Practice |
| spelling | doaj-art-b1cbacb842e548c7b13f4430ab2fa5032025-08-20T01:53:26ZengBMCNeurological Research and Practice2524-34892025-05-01711810.1186/s42466-025-00384-1Long-term outcomes of community-based intensive care treatment following neurological early rehabilitation– results of a multicentric German studyBernadette Einhäupl0Danae Götze1Stephanie Reichl2Lina Willacker3Romy Pletz4Thomas Kohlmann5Esther Henning6Lena Schmeyers7Andreas Straube8Rebekka Süss9Steffen Fleßa10Simone Schmidt11Jens D. Rollnik12Friedemann Müller13Aukje Bartsch-de Jong14Svenja Blömeke15Jennifer Hartl16Nuria Vallejo17Daniel Liedert18Thomas Olander19Volker Ziegler20Renate Weinhardt21Felix Schlachetzki22Tatjana Groß23Susanne Hirmer24Lea Dillbaner25Lisa Kleinlein26Thomas Platz27Andreas Bender28Department of Neurology, LMU University Hospital, LMU MunichDepartment of Neurology, LMU University Hospital, LMU MunichNeurorehabilitation Research Group, Faculty of Medicine, University of GreifswaldDepartment of Neurology, LMU University Hospital, LMU MunichNeurorehabilitation Research Group, Faculty of Medicine, University of GreifswaldInstitute for Community Medicine, Department Methods of Community Medicine, University Medicine GreifswaldInstitute for Community Medicine, Department Methods of Community Medicine, University Medicine GreifswaldFaculty of Law and Economics, Chair of General Business Administration and Health Care Management, University GreifswaldDepartment of Neurology, LMU University Hospital, LMU MunichFaculty of Law and Economics, Chair of General Business Administration and Health Care Management, University GreifswaldFaculty of Law and Economics, Chair of General Business Administration and Health Care Management, University GreifswaldInstitute for Neurorehabilitation Research (InFo), BDH-Clinic Hessisch Oldendorf, Affiliated Institute of Hannover Medical SchoolInstitute for Neurorehabilitation Research (InFo), BDH-Clinic Hessisch Oldendorf, Affiliated Institute of Hannover Medical SchoolSchön Clinic Bad Aibling-HarthausenSchön Clinic Bad Aibling-HarthausenSchön Clinic Bad Aibling-HarthausenSchön Clinic Bad Aibling-HarthausenTherapiezentrum Burgau, Hospital for Neurological RehabilitationTherapiezentrum Burgau, Hospital for Neurological RehabilitationTherapiezentrum Burgau, Hospital for Neurological RehabilitationHospital for Neurological Rehabilitation, Rhön-ClinicHospital for Neurological Rehabilitation, Rhön-ClinicDepartment of Neurology, Centre of Vascular Neurology and Intensive Care, medbo Bezirksklinikum Regensburg, University of RegensburgDepartment of Neurology, Centre of Vascular Neurology and Intensive Care, medbo Bezirksklinikum Regensburg, University of RegensburgDepartment of Neurology, Centre of Vascular Neurology and Intensive Care, medbo Bezirksklinikum Regensburg, University of RegensburgDepartment of Neurology, Centre of Vascular Neurology and Intensive Care, medbo Bezirksklinikum Regensburg, University of RegensburgStatistical Consulting StaBLab, Department of Statistics, LMU MunichNeurorehabilitation Research Group, Faculty of Medicine, University of GreifswaldDepartment of Neurology, LMU University Hospital, LMU MunichAbstract Background Weaning from mechanical ventilation (MV) and tracheal cannula (TC) during neurological early rehabilitation (NER) is mostly successful. However, some patients leave NER with TC/MV, requiring home-based specialized intensive care nursing (HSICN). Data on medical and demographic characteristics and long-term outcomes of these patients are limited. Methods A multicentric retrospective observational study across five German NER hospitals collected data from neurological patients with TC/MV at discharge. The study aimed to assess patients’ health status at NER discharge, and to identify predictors of post-discharge survival. Survival rates were analyzed using Kaplan-Meier estimates; further predictors of survival post-discharge were analyzed using Cox regression. Results Among 312 patients, the one-year survival rate was 61.9%, decreasing to 38.1% after approximately 4 years. Older age, higher overall morbidity and discharge with MV were associated with an increased likelihood of death, while a longer stay in NER correlated with survival. Conclusions Patients requiring HSICN after discharge from NER have a high mortality rate. Identifying survival predictors may help to identify patients at risk, and thus could be integrated into the decision-making process for NER discharge. The high mortality post-discharge warrants an evaluation of the current post-hospital care model. Optimizing therapeutic care in the HSICN setting may have the potential to reduce mortality and neuro-disability, and enhance the quality of life in these neurologically severely affected patients. Trial registration The trial OptiNIV - Retrospective study of post-hospital intensive care in neurological patients has been retrospectively registered in the German Clinical Trials Register (DRKS) since 28.10.2022 with the ID DRKS00030580.https://doi.org/10.1186/s42466-025-00384-1RehabilitationWeaningSurvival rateTracheal cannulaMechanical ventilationStroke |
| spellingShingle | Bernadette Einhäupl Danae Götze Stephanie Reichl Lina Willacker Romy Pletz Thomas Kohlmann Esther Henning Lena Schmeyers Andreas Straube Rebekka Süss Steffen Fleßa Simone Schmidt Jens D. Rollnik Friedemann Müller Aukje Bartsch-de Jong Svenja Blömeke Jennifer Hartl Nuria Vallejo Daniel Liedert Thomas Olander Volker Ziegler Renate Weinhardt Felix Schlachetzki Tatjana Groß Susanne Hirmer Lea Dillbaner Lisa Kleinlein Thomas Platz Andreas Bender Long-term outcomes of community-based intensive care treatment following neurological early rehabilitation– results of a multicentric German study Neurological Research and Practice Rehabilitation Weaning Survival rate Tracheal cannula Mechanical ventilation Stroke |
| title | Long-term outcomes of community-based intensive care treatment following neurological early rehabilitation– results of a multicentric German study |
| title_full | Long-term outcomes of community-based intensive care treatment following neurological early rehabilitation– results of a multicentric German study |
| title_fullStr | Long-term outcomes of community-based intensive care treatment following neurological early rehabilitation– results of a multicentric German study |
| title_full_unstemmed | Long-term outcomes of community-based intensive care treatment following neurological early rehabilitation– results of a multicentric German study |
| title_short | Long-term outcomes of community-based intensive care treatment following neurological early rehabilitation– results of a multicentric German study |
| title_sort | long term outcomes of community based intensive care treatment following neurological early rehabilitation results of a multicentric german study |
| topic | Rehabilitation Weaning Survival rate Tracheal cannula Mechanical ventilation Stroke |
| url | https://doi.org/10.1186/s42466-025-00384-1 |
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