BACKGROUND: An increasing number of patients require prolonged mechanical ventilation (PMV), which is associated with high morbidity and poor long-term survival, but there are few data regarding the incidence and outcome of PMV patients from a community perspective. METHODS: We retrospectively reviewed the electronic medical records of adult Olmsted county, Minnesota, residents admitted to the intensive care units at the 2 Mayo Clinic Rochester hospitals from January 1, 2003, to December 31, 2007, who underwent tracheostomy for PMV. RESULTS: Sixty-five patients, median age 68 years (interquartile range [IQR] 49-80 y), 39 male, underwent tracheostomy for PMV, resulting in an age-adjusted incidence of 13 (95% CI 10-17) per 100,000 patient-years at risk. The median number of days on mechanical ventilation was 24 days (IQR 18-37 d). Forty-six patients (71%) survived to hospital discharge, and 36 (55%) were alive at 1-year follow-up. After adjusting for age and baseline severity of illness, the presence of COPD was independently associated with 1-year mortality (hazard ratio 3.4, 95% CI 1.4-8.2%). CONCLUSIONS: There was a considerable incidence of tracheostomy for PMV. The presence of COPD was an independent predictor of 1-year mortality.
BACKGROUND: An increasing number of patients require prolonged mechanical ventilation (PMV), which is associated with high morbidity and poor long-term survival, but there are few data regarding the incidence and outcome of PMVpatients from a community perspective. METHODS: We retrospectively reviewed the electronic medical records of adult Olmsted county, Minnesota, residents admitted to the intensive care units at the 2 Mayo Clinic Rochester hospitals from January 1, 2003, to December 31, 2007, who underwent tracheostomy for PMV. RESULTS: Sixty-five patients, median age 68 years (interquartile range [IQR] 49-80 y), 39 male, underwent tracheostomy for PMV, resulting in an age-adjusted incidence of 13 (95% CI 10-17) per 100,000 patient-years at risk. The median number of days on mechanical ventilation was 24 days (IQR 18-37 d). Forty-six patients (71%) survived to hospital discharge, and 36 (55%) were alive at 1-year follow-up. After adjusting for age and baseline severity of illness, the presence of COPD was independently associated with 1-year mortality (hazard ratio 3.4, 95% CI 1.4-8.2%). CONCLUSIONS: There was a considerable incidence of tracheostomy for PMV. The presence of COPD was an independent predictor of 1-year mortality.
Authors: David J Scheinhorn; Meg Stearn Hassenpflug; John J Votto; David C Chao; Scott K Epstein; Gordon S Doig; E Bert Knight; Richard A Petrak Journal: Chest Date: 2007-01 Impact factor: 9.410
Authors: David J Scheinhorn; Meg Stearn Hassenpflug; John J Votto; David C Chao; Scott K Epstein; Gordon S Doig; E Bert Knight; Richard A Petrak Journal: Chest Date: 2007-01 Impact factor: 9.410
Authors: Neil R MacIntyre; Scott K Epstein; Shannon Carson; David Scheinhorn; Kent Christopher; Sean Muldoon Journal: Chest Date: 2005-12 Impact factor: 9.410
Authors: Christopher E Cox; Shannon S Carson; Jennifer H Lindquist; Maren K Olsen; Joseph A Govert; Lakshmipathi Chelluri Journal: Crit Care Date: 2007 Impact factor: 9.097
Authors: Stephanie M Sison; Gayathri K Sivakumar; Christine Caufield-Noll; William B Greenough; Esther S Oh; Panagis Galiatsatos Journal: Heliyon Date: 2021-02-13