Supplementary Material for: Outcomes after Prolonged Weaning in Chronic Obstructive Pulmonary Disease Patients: Data from the German WeanNet Initiative

<b><i>Background:</i></b> The outcome of prolonged weaning in COPD patients is still unclear. <b><i>Methods:</i></b> A subgroup analysis of 2,937 COPD patients (median: age 69 years, 5 comorbidities, 43% female) from the entire WeanNet cohort of specialized German weaning centers previously published (<i>N</i> = 11,424) was performed. <b><i>Results:</i></b> Weaning outcomes were as follows: successful weaning without subsequent long-term noninvasive ventilation (NIV): <i>N</i> = 900; 30.6%; successful weaning with subsequent long-term NIV: <i>N</i> = 900; 30.6%; weaning failure with subsequent long-term invasive ventilation: <i>N</i> = 780; 26.6%; and death: <i>N</i> = 357; 12.2%. Most important predictors of mortality and weaning failure were advanced age and duration of mechanical ventilation in the transferring ICU, respectively. On discharge, the tracheostoma was closed in only 53% and 59% of patients with successful weaning not receiving and receiving long-term NIV, respectively. Unsuccessfully weaned patients were predominantly discharged home (20.5%) or to long-term care facilities (57.2%). Successfully weaned patients were predominantly discharged home (22.4%/35.9%: without/with NIV) and to rehabilitation (41.0%/43.1%: without/with NIV), respectively. <b><i>Conclusion:</i></b> COPD forms an important subgroup of prolonged weaning patients. Following transfer from the ICU to a specialized weaning center, weaning is successful more than 60%. Importantly, both tracheostomy status and initial destination following discharge are highly dependent on the weaning outcome.

**背景**：慢性阻塞性肺疾病（Chronic Obstructive Pulmonary Disease, COPD）患者的长期机械通气脱机结局目前仍不明确。
**方法**：本研究对既往已发表的、来自德国专科脱机中心的完整WeanNet队列（总样本量11424例）中的2937例慢性阻塞性肺疾病患者进行亚组分析；该亚组患者的中位年龄为69岁，合并症数量为5种，女性占比43%。
**结果**：患者的脱机结局如下：成功脱机且后续无需长期无创通气（Noninvasive Ventilation, NIV）：900例，占比30.6%；成功脱机且后续需长期无创通气：900例，占比30.6%；脱机失败且后续需长期有创通气：780例，占比26.6%；死亡：357例，占比12.2%。影响患者死亡与脱机失败的最重要预测因素分别为高龄，以及转诊前所在重症监护病房（Intensive Care Unit, ICU）内的机械通气时长。出院时，成功脱机且未接受长期无创通气的患者中，仅53%完成了气管造口闭合；成功脱机且接受长期无创通气的患者中，该比例为59%。脱机失败的患者主要出院去向为家庭（20.5%）或长期护理机构（57.2%）；成功脱机的患者则主要出院去向为家庭（未接受长期无创通气者占22.4%，接受长期无创通气者占35.9%）与康复机构（未接受长期无创通气者占41.0%，接受长期无创通气者占43.1%）。
**结论**：慢性阻塞性肺疾病患者是长期机械通气脱机患者中的重要亚组人群。从重症监护病房转诊至专科脱机中心后，患者脱机成功率超过60%。值得关注的是，气管造口状态与出院初始去向均与脱机结局密切相关。