Patterns of referral for inpatient transfer to a UK specialist weaning and complex home ventilation unit

Résumé fourni par la source

Specialised weaning and complex home ventilation units provide care for patients with chronic respiratory failure needing long-term mechanical ventilation. These units accept referrals for transfer from respiratory, high dependency or intensive care units for patients requiring home non-invasive ventilation (NIV, Level 2), weaning from prolonged ventilation or long-term tracheostomy ventilation (Level 3). Patterns of referral are poorly understood. We analysed data from inpatient referrals made electronically between October 2020 and December 2023. Referrals were categorised as: Level 2, Level 3 or Remote referrals for NIV setup at referring centres. 713 referrals were made for 609 patients from 69 hospitals (Age 64 [IQR 50-72] years, 51% male). Diagnoses were neuromuscular disease (n=251, 35%), COPD (n=171, 25%), obesity hypoventilation syndrome (n=176, 24%), chest wall disease (n=20, 3%) and other (n=95, 13%). Referrals were for L3 transfer (n=256, 36%), L2 transfer (n=261, 37%), or remote (n=196, 27%). Time to initial review was 1 day (IQR 0-2) and to final decision 4 days (IQR 1-10). Overall rejection rate was 34.8%, with 26% of these accepted upon re-referral. Table 1 shows referral patterns for each pathway. Our analysis indicates rapid review of referrals and flexible care pathways accommodating a diverse patient cohort. erj;66/suppl_69/PA5231/F1 F1 F1

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