Predictors of 1-year Mortality in Patients on Prolonged Mechanical Ventilation After Surgery in Intensive Care Unit: a Multicenter, Retrospective Cohort Study

Overview

Journal BMC Anesthesiol

Publisher Biomed Central

Specialty Anesthesiology

Date 2020 Feb 23

PMID 32085744

Citations 6

Authors

Yueming Sun

Shuangling Li

Shupeng Wang

Chen Li

Gang Li

Jiaxuan Xu

Hongzhi Wang

Fei Liu

Gaiqi Yao

Zhigang Chang

Yalin Liu

Meixia Shang

Dongxin Wang

Affiliations

Soon will be listed here.

Abstract

Objectives: The requirement of prolonged mechanical ventilation (PMV) is associated with increased medical care demand and expenses, high early and long-term mortality, and worse life quality. However, no study has assessed the prognostic factors associated with 1-year mortality among PMV patients, not less than 21 days after surgery. This study analyzed the predictors of 1-year mortality in patients requiring PMV in intensive care units (ICUs) after surgery.

Methods: In this multicenter, respective cohort study, 124 patients who required PMV after surgery in the ICUs of five tertiary hospitals in Beijing between January 2007 and June 2016 were enrolled. The primary outcome was the duration of survival within 1 year. Predictors of 1-year mortality were identified with a multivariable Cox proportional hazard model. The predictive effect of the ProVent score was also validated.

Results: Of the 124 patients enrolled, the cumulative 1-year mortality was 74.2% (92/124). From the multivariable Cox proportional hazard analysis, cancer diagnosis (hazard ratio [HR] 2.14, 95% confidence interval [CI] 1.37-3.35; P < 0.01), no tracheostomy (HR 2.01, 95% CI 1.22-3.30; P < 0.01), enteral nutrition intolerance (HR 1.88, 95% CI 1.19-2.97; P = 0.01), blood platelet count ≤150 × 10/L (HR 1.77, 95% CI 1.14-2.75; P = 0.01), requirement of vasopressors (HR 1.78, 95% CI 1.13-2.80; P = 0.02), and renal replacement therapy (HR 1.71, 95% CI 1.01-2.91; P = 0.047) on the 21st day of mechanical ventilation (MV) were associated with shortened 1-year survival.

Conclusions: For patients who required PMV after surgery, cancer diagnosis, no tracheostomy, enteral nutrition intolerance, blood platelet count ≤150 × 10/L, vasopressor requirement, and renal replacement therapy on the 21st day of MV were associated with shortened 1-year survival. The prognosis in PMV patients in ICUs can facilitate the decision-making process of physicians and patients' family members on treatment schedule.

Citing Articles

Development of a Prognostic Scoring System for Tracheostomized Patients Requiring Prolonged Ventilator Care: A Ten-Year Experience in a University-Affiliated Tertiary Hospital.

Jang H, Yoo W, Seong H, Kim S, Kim S, Jo E Medicina (Kaunas). 2024; 60(2).

PMID: 38399567 PMC: 10890453. DOI: 10.3390/medicina60020280.

Severe Obesity and Prolonged Postoperative Mechanical Ventilation in Elderly Vascular Surgery Patients.

Khanna N, Gbadegesin S, Reline T, Tobias J, Nafiu O J Clin Med Res. 2022; 14(9):341-347.

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External validation of the ProVent score for prognostication of 1-year mortality of critically ill patients with prolonged mechanical ventilation: a single-centre, retrospective observational study in Austria.

Dibiasi C, Kimberger O, Bologheanu R, Staudinger T, Heinz G, Zauner C BMJ Open. 2022; 12(9):e066197.

PMID: 36127078 PMC: 9490575. DOI: 10.1136/bmjopen-2022-066197.

Motor Simulation as an Adjunct to Patient Recovery Process Following Intensive Care Unit Admission.

Calmels C, Le Garrec S, Brocherie F Front Med (Lausanne). 2022; 9:868514.

PMID: 35372455 PMC: 8968139. DOI: 10.3389/fmed.2022.868514.

Extubation in the operating room results in fewer composite mechanical ventilation-related adverse outcomes in patients after liver transplantation: a retrospective cohort study.

Xu Y, Zuo Y, Zhou L, Hao X, Xiao X, Ye M BMC Anesthesiol. 2021; 21(1):286.

PMID: 34794387 PMC: 8600887. DOI: 10.1186/s12871-021-01508-1.

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