scholarly journals Outcomes of and Lessons Learned from Patients with Severe COVID-19 in a Long-term Acute Care Hospital

2021 ◽  
Vol 102 (4) ◽  
pp. e3-e4
Author(s):  
Peter Grevelding ◽  
Henry Hrdlicka ◽  
Stephen Holland ◽  
Lorraine Cullen ◽  
Amanda Meyer ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospital ◽  
Lessons Learned ◽  
Care Hospital

scholarly journals Patient Outcomes and Lessons-Learned from Treating Patients with Severe COVID-19 at a Long-Term Acute Care Hospital

2021 ◽  
Author(s):  
Peter Grevelding ◽  
Henry C Hrdlicka ◽  
Stephen Holland ◽  
Lorraine Cullen ◽  
Amanda Meyer ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Acute Care ◽  
Patient Outcomes ◽  
Acute Care Hospital ◽  
Lessons Learned ◽  
Care Hospital ◽  
Patient Age ◽  
Holistic Treatment ◽  
Patient Âgé

The goal of this study was to describe the characteristics, clinical management, and patient outcomes during, and after, acute COVID-19 phase at Gaylord Specialty Healthcare, a long-term acute care hospital in Wallingford, CT, USA. In this study, we conducted a single-center retrospective analysis of electronic medical records of patients treated for COVID-19-related impairments, from March 19, 2020 through August 14, 2020, to evaluate patient outcomes in response to holistic treatment approach used at our facility. Of the 127 total COVID-19 related patient admissions during this time, 118 were discharged by the data cut-off. Mean patient age was 63 years, 64.1% were male, and 29.9% of patients tested-positive for SARS-CoV-2 infection at admission. The mean (SD) length-of-stay at was 25.5 (13.0) days and there was a positive correlation between patient age and length-of-stay. Of the 51 patients non-ambulatory at admission, 83.3% were ambulatory at discharge. Gait increased 217.4 feet from admission to discharge, a greater increase than the reference cohort of 146.3 feet. 93.8% (15/16) of patients mechanically ventilated at admission were weaned before discharge (mean 11.3 days). 74.7% (56/75) of patients admitted with a restricted diet were discharged on a regular diet. In conclusion, the majority of patients treated at our long-term acute care hospital for severe COVID-19 and related complications improved significantly through coordinated care and rehabilitation.

Patient Outcomes and Lessons-Learned from Treating Patients with Severe COVID-19 at a Long-Term Acute Care Hospital (Preprint)

2021 ◽  
Author(s):  
Peter Grevelding ◽  
Henry Charles Hrdlicka ◽  
Stephen Holland ◽  
Lorraine Cullen ◽  
Amanda Meyer ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Acute Care ◽  
Patient Outcomes ◽  
Acute Care Hospital ◽  
Lessons Learned ◽  
Care Hospital ◽  
Patient Age ◽  
Holistic Treatment ◽  
Patient Âgé

BACKGROUND Patients hospitalized with severe coronavirus disease-2019 (COVID-19) may face long hospital lengths-of-stay, making it unreasonable to expect a discharge to home without long-term consequences.Post-acute care, such as that provided at long-term acute care hospitals (LTACHs) can provide rehabilitation and/or palliative care in the post-COVID phase, as well as provide an alternative to conventional short-term acute care hospitalization (STACH) for active treatment, thereby reducing the burden on the STACH system. OBJECTIVE To describe characteristics, clinical management, and patient outcomes during and after acute COVID-19 phase in a LTACH in the Northeastern United States. METHODS A single-center retrospective analysis of electronic medical records of patients treated for COVID-19-related impairments, from March 19, 2020 through August 14, 2020, was conducted to evaluate patient outcomes in response to the facility’s holistic treatment approach. RESULTS Of the 127 total COVID-19 related patient admissions during this time, 118 admissions were discharged by the data cut-off. Mean patient age was 63 years, 64.1% were male, and 29.9% of patients tested-positive for SARS-CoV-2 infection at admission. The mean (SD) length-of-stay at was 25.5 (13.0) days and there was a positive correlation between patient age and length-of-stay. Of the 51 patients non-ambulatory at admission, 83.3% were ambulatory at discharge. Gait increased 217.4 feet from admission to discharge, a greater increase than the reference cohort of 146.3 feet. 93.8% (15/16) of patients mechanically ventilated at admission were weaned before discharge (mean 11.3 days). 74.7% (56/75) of patients admitted with a restricted diet were discharged on a regular diet. CONCLUSIONS The majority of patients treated at a long-term acute care hospital for severe COVID-19 and related complications improved significantly through coordinated care and rehabilitation.

scholarly journals Investigation of a Group A Streptococcal Outbreak Among Residents of a Long-term Acute Care Hospital

2011 ◽  
Vol 52 (8) ◽  
pp. 988-994 ◽  
Author(s):  
M. Deutscher ◽  
S. Schillie ◽  
C. Gould ◽  
J. Baumbach ◽  
M. Mueller ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Group A

Chronic Comorbid Illnesses Predict the Clinical Course of 866 Patients Requiring Prolonged Mechanical Ventilation in a Long-Term, Acute-Care Hospital

2018 ◽  
Vol 35 (8) ◽  
pp. 745-754 ◽  
Author(s):  
J. Dermot Frengley ◽  
Giorgio R. Sansone ◽  
Robert J. Kaner
Keyword(s):  
Mechanical Ventilation ◽  
Acute Care ◽  
Clinical Course ◽  
Prolonged Mechanical Ventilation ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Term Survival ◽  
Group A ◽  
Chronically Critically Ill

Objective: To determine whether burdens of chronic comorbid illnesses can predict the clinical course of prolonged mechanical ventilation (PMV)patients in a long-term, acute-care hospital (LTACH). Methods: Retrospective study of 866 consecutive PMV patients whose burdens of chronic comorbid illnesses were quantified using the Cumulative Illness Rating Scale (CIRS). Based on increasing CIRS scores, 6 groups were formed and compared: group A (≤25; n = 97), group B (26-28; n = 105), group C (29-31; n = 181), group D (32-34; n = 208), group E (35-37; n = 173), and group F (>37; n = 102). Results: As CIRS scores increased from group A to group F, rates of weaning success, home discharges, and LTACH survival declined progressively from 74% to 17%, 48% to 0%, and 79% to 21%, respectively (all P < .001). Negative correlations between the mean score of each CIRS group and correspondent outcomes also supported patients’ group allocation and an accurate prediction of their clinical course (all P < .01). Long-term survival progressively declined from a median survival time of 38.9 months in group A to 3.2 months in group F ( P < .001). Compared to group A, risk of death was 75% greater in group F ( P = .03). Noteworthy, PMV patients with CIRS score <25 showed greater ability to recover and a low likelihood of becoming chronically critically ill. Diagnostic accuracy of CIRS to predict likelihood of weaning success, home discharges, both LTACH and long-term survival was good (area under the curves ≥0.71; all P <.001). Conclusions: The burden of chronic comorbid illnesses was a strong prognostic indicator of the clinical course of PMV patients. Patients with lower CIRS values showed greater ability to recover and were less likely to become chronically critically ill. Thus, CIRS can be used to help guide clinicians caring for PMV patients in transfer decisions to and from postacute care setting.

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