Survivors of acute respiratory failure (ARF) commonly experience long-lasting physical, cognitive, and/or mental health impairments. Unmet medication needs occurring immediately after hospital discharge may have an important effect on subsequent recovery. In this multicenter prospective cohort study, we enrolled ARF survivors who were discharged directly home from their acute care hospitalization. The primary exposure was unmet medication needs. The primary outcome was hospital readmission or death within 3 months after discharge. We performed a propensity score analysis, using inverse probability weighting for the primary exposure, to evaluate the exposure–outcome association, with an a priori sample size of 200 ARF survivors. We enrolled 200 ARF survivors, of whom 107 (53%) were female and 77 (39%) were people of color. Median (IQR) age was 55 (43–66) years, APACHE II score 20 (15–26) points, and hospital length of stay 14 (9–21) days. Of the 200 participants, 195 (98%) were in the analytic cohort. One hundred fourteen (57%) patients had at least one unmet medication need; the proportion of medication needs that were unmet was 6% (0–15%). Fifty-six (29%) patients were readmitted or died by 3 months; 10 (5%) died within 3 months. Unmet needs were not associated (risk ratio 1.25; 95% CI 0.75–2.1) with hospital readmission or death, although a higher proportion of unmet needs may have been associated with increased hospital readmission (risk ratio 1.7; 95% CI 0.96–3.1) and decreased mortality (risk ratio 0.13; 95% CI 0.02–0.99). Unmet medication needs are common among survivors of acute respiratory failure shortly after discharge home. The association of unmet medication needs with 3-month readmission and mortality is complex and requires additional investigation to inform clinical trials of interventions to reduce unmet medication needs. Study registration number: NCT03738774 . The study was prospectively registered before enrollment of the first patient.

中文翻译：

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急性呼吸衰竭幸存者出院后未满足的药物需求与再入院或死亡之间的关联：解决重症监护后综合征 (APICS-01) 多中心前瞻性队列研究

急性呼吸衰竭 (ARF) 的幸存者通常会经历长期的身体、认知和/或心理健康损害。出院后立即出现未满足的药物需求可能对随后的康复产生重要影响。在这项多中心前瞻性队列研究中，我们招募了 ARF 幸存者，这些幸存者从急性护理住院中直接出院回家。主要暴露是未满足的药物需求。主要结局是出院后 3 个月内再次入院或死亡。我们进行了倾向评分分析，对主要暴露使用逆概率加权，以评估暴露-结果关联，先验样本量为 200 名 ARF 幸存者。我们招募了 200 名 ARF 幸存者，其中 107 名 (53%) 为女性，77 名 (39%) 为有色人种。中位 (IQR) 年龄为 55 (43-66) 岁，APACHE II 评分为 20 (15-26) 分，住院时间为 14 (9-21) 天。在 200 名参与者中，195 名（98%）在分析队列中。114 (57%) 名患者至少有一项未满足的药物需求；未满足的药物需求比例为 6%（0-15%）。56 名 (29%) 患者在 3 个月内再次入院或死亡；10 (5%) 人在 3 个月内死亡。未满足的需求与再次入院或死亡无关（风险比 1.25；95% CI 0.75–2.1），尽管较高比例的未满足需求可能与再次入院增加相关（风险比 1.7；95% CI 0.96–3.1）死亡率降低（风险比 0.13；95% CI 0.02–0.99）。出院后不久，急性呼吸衰竭幸存者的药物需求未得到满足是很常见的。未满足的药物需求与 3 个月再入院和死亡率之间的关联是复杂的，需要进行额外调查，以告知临床试验干预措施以减少未满足的药物需求。研究登记号：NCT03738774。该研究在第一位患者入组前进行了前瞻性注册。