PURPOSE: The purpose of the study is to evaluate outcomes and objective parameters related to poor prognosis in patients who were defined as prolonged acute mechanical ventilation (PAMV; ventilator care ≥96 hours) in the medical intensive care unit of a university-affiliated tertiary care hospital in Korea. MATERIAL AND METHODS: We analyzed retrospectively clinical data gathered from the medical records on day 4 of MV between 2008 and 2013. In total, 311 were categorized as PAMV. RESULTS: Their median age was 67 years (range, 18-93 years), and 71.7% were male. The 28-day mortality rate after intensive care unit admission was 34.7%. Four variables on day 4 of mechanical ventilation (need for neuromuscular blockers [hazard ratio {HR}, 2.432; 95% confidence interval, 1.337-4.422], need for vasopressors [HR, 2.312; 95% confidence interval, 1.258-4.248], need for hemodialyses [HR, 1.913; 95% confidence interval, 1.018-3.595], and body mass index ≤21 kg/m(2) [HR, 1.827; 95% confidence interval, 1.015-3.288]) were independent factors associated with mortality based on a Cox proportional hazards model. As the number of these prognostic factors increased, the survival rate decreased. CONCLUSIONS: Four clinical factors (body mass index ≤21, requirement for neuromuscular blockers, vasopressors, and hemodialysis) on day 4 of mechanical ventilation were associated with 28-day mortality in PAMV patients.
PURPOSE: The purpose of the study is to evaluate outcomes and objective parameters related to poor prognosis in patients who were defined as prolonged acute mechanical ventilation (PAMV; ventilator care ≥96 hours) in the medical intensive care unit of a university-affiliated tertiary care hospital in Korea. MATERIAL AND METHODS: We analyzed retrospectively clinical data gathered from the medical records on day 4 of MV between 2008 and 2013. In total, 311 were categorized as PAMV. RESULTS: Their median age was 67 years (range, 18-93 years), and 71.7% were male. The 28-day mortality rate after intensive care unit admission was 34.7%. Four variables on day 4 of mechanical ventilation (need for neuromuscular blockers [hazard ratio {HR}, 2.432; 95% confidence interval, 1.337-4.422], need for vasopressors [HR, 2.312; 95% confidence interval, 1.258-4.248], need for hemodialyses [HR, 1.913; 95% confidence interval, 1.018-3.595], and body mass index ≤21 kg/m(2) [HR, 1.827; 95% confidence interval, 1.015-3.288]) were independent factors associated with mortality based on a Cox proportional hazards model. As the number of these prognostic factors increased, the survival rate decreased. CONCLUSIONS: Four clinical factors (body mass index ≤21, requirement for neuromuscular blockers, vasopressors, and hemodialysis) on day 4 of mechanical ventilation were associated with 28-day mortality in PAMVpatients.
Authors: Seung Eon Song; Sang Hee Lee; Eun-Jung Jo; Jung Seop Eom; Jeong Ha Mok; Mi-Hyun Kim; Ki Uk Kim; Min Ki Lee; Kwangha Lee Journal: Tuberc Respir Dis (Seoul) Date: 2016-10-05