BACKGROUND: Age and duration of mechanical ventilation (MV) are strongly associated with mortality and hospital discharge disposition. METHODS: Electronic administrative records from a 425-bed community teaching hospital were obtained for 9,912 patients who were admitted to hospital ICUs between 2003 and 2008. Risk estimates of age and duration of MV for in-hospital mortality and discharge to home vs extended-care facilities (ECFs) also were obtained. RESULTS: Of 9,912 patients, 37 were discharged to hospice care, and 668 were < 18 years of age. Of the remaining 9,207 patients, 4,238 received invasive MV. Mortality or hospital discharge to ECFs increased consistently for each decade of age > 65 years and as the duration of MV increased. Although only 11.7% of patients < 65 years age who received MV for 1 or 2 days died during hospitalization, the mortality rate increased to 72.1% for patients > 85 years of age who had received MV for > 7 days. For patients requiring MV for >or= 7 days, < 10% of the >or= 65 years of age and < 5% of patients >or= 85 years of age survived to be discharged home from the hospital. Multivariate logistic regression analyses showed that age > 65 years and duration of MV remained significantly associated with outcomes, even after adjustment for hospital discharge diagnoses (Charlson scores). CONCLUSIONS: This study suggests that age and duration of MV are strongly associated with mortality and posthospital disposition. If confirmed, the simple combination of age and duration of MV provides prognostic information that could be used with trajectory of illness and in the context of patients' values to inform end-of-life discussions with patients or their surrogates during a trial of critical care.
BACKGROUND: Age and duration of mechanical ventilation (MV) are strongly associated with mortality and hospital discharge disposition. METHODS: Electronic administrative records from a 425-bed community teaching hospital were obtained for 9,912 patients who were admitted to hospital ICUs between 2003 and 2008. Risk estimates of age and duration of MV for in-hospital mortality and discharge to home vs extended-care facilities (ECFs) also were obtained. RESULTS: Of 9,912 patients, 37 were discharged to hospice care, and 668 were < 18 years of age. Of the remaining 9,207 patients, 4,238 received invasive MV. Mortality or hospital discharge to ECFs increased consistently for each decade of age > 65 years and as the duration of MV increased. Although only 11.7% of patients < 65 years age who received MV for 1 or 2 days died during hospitalization, the mortality rate increased to 72.1% for patients > 85 years of age who had received MV for > 7 days. For patients requiring MV for >or= 7 days, < 10% of the >or= 65 years of age and < 5% of patients >or= 85 years of age survived to be discharged home from the hospital. Multivariate logistic regression analyses showed that age > 65 years and duration of MV remained significantly associated with outcomes, even after adjustment for hospital discharge diagnoses (Charlson scores). CONCLUSIONS: This study suggests that age and duration of MV are strongly associated with mortality and posthospital disposition. If confirmed, the simple combination of age and duration of MV provides prognostic information that could be used with trajectory of illness and in the context of patients' values to inform end-of-life discussions with patients or their surrogates during a trial of critical care.
Authors: Brian K Gehlbach; Victor R Salamanca; Joseph E Levitt; Greg A Sachs; Mary Kate Sweeney; Anne S Pohlman; Jeff Charbeneau; Jerry A Krishnan; Jesse B Hall Journal: Am J Crit Care Date: 2011-09 Impact factor: 2.228
Authors: L E M Haas; Ilse van Beusekom; Diederik van Dijk; Marije E Hamaker; Ferishta Bakhshi-Raiez; Dylan W de Lange; Nicolette F de Keizer Journal: Intensive Care Med Date: 2018-09-25 Impact factor: 17.440
Authors: Curtis H Weiss; Farzad Moazed; Colleen A McEvoy; Benjamin D Singer; Igal Szleifer; Luís A N Amaral; Mary Kwasny; Charles M Watts; Stephen D Persell; David W Baker; Jacob I Sznajder; Richard G Wunderink Journal: Am J Respir Crit Care Med Date: 2011-05-26 Impact factor: 21.405
Authors: Christopher W Seymour; Pratik P Pandharipande; Tyler Koestner; Leonard D Hudson; Jennifer L Thompson; Ayumi K Shintani; E Wesley Ely; Timothy D Girard Journal: Crit Care Med Date: 2012-10 Impact factor: 7.598
Authors: Kei Ouchi; Guruprasad D Jambaulikar; Samuel Hohmann; Naomi R George; Emily L Aaronson; Rebecca Sudore; Mara A Schonberg; James A Tulsky; Jeremiah D Schuur; Daniel J Pallin Journal: J Am Geriatr Soc Date: 2018-03-15 Impact factor: 5.562
Authors: M S Valentine; P A Link; J A Herbert; F J Kamga Gninzeko; M B Schneck; K Shankar; J Nkwocha; A M Reynolds; R L Heise Journal: Cell Mol Bioeng Date: 2018-06-19 Impact factor: 2.321
Authors: Jehan Alladina; Sean D Levy; Josalyn L Cho; Kelsey L Brait; Sowmya R Rao; Alexander Camacho; Kathryn A Hibbert; R Scott Harris; Benjamin D Medoff; James L Januzzi; B Taylor Thompson; Ednan K Bajwa Journal: Am J Respir Crit Care Med Date: 2021-05-15 Impact factor: 21.405