Predictive value of mechanical power on the in-hospital mortality in critical ill patients with mechanical ventilation in emergency department
10.3760/cma.j.issn.1671-0282.2023.08.005
- VernacularTitle:机械能对急诊机械通气患者院内死亡风险的预测价值
- Author:
Yongcheng ZHU
1
;
Jun HE
;
Xiaohui CHEN
;
Shuangwei WANG
;
Guifeng GAO
;
Junrong MO
;
Ruiqiang WANG
;
Yunmei LI
;
Xuezhen FENG
;
Huilin JIANG
;
Peiyi LIN
;
Min LI
Author Information
1. 广州医科大学附属第二医院急诊部，广州 510260
- Keywords:
Mechanical power;
Mechanical ventilation;
Emergency department;
Prognostic assessment;
SOFA score
- From:
Chinese Journal of Emergency Medicine
2023;32(8):1034-1038
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the predictive value of mechanical power (MP) on the risk of in-hospital mortality in critical ill patients in emergency department.Methods:A total of 105 critical ill patients with invasive mechanical ventilation in the Department of Emergency of Second Affiliated Hospital of Guangzhou Medical University between December 1, 2017 and October 31, 2020 were retrospectively analyzed. Based on the clinical prognosis, the patients were divided into the in-hospital survival group (80 patients) and the in-hospital death group (25 patients). The clinical data and ventilator parameters were recorded, and the MP of the two groups was calculated in order to assess the predictive efficacy of MP on in-hospital death.Results:Compared to the in-hospital death group, the oxygenation index PaO 2/FiO 2 was significantly higher (271 mmHg vs. 217 mmHg, P=0.020) and blood lactate (1.59 mmol/L vs. 2.56 mmol/L, P<0.001) and procalcitonin (0.31 ng/mL vs. 3.55 ng/mL, P=0.028), minute ventilation (7.03 L/min vs.8.32 mmol/L, P=0.013), MP (14.37 J/min vs. 16.12 J/min, P=0.041), SOFA score (5 vs. 8, P=0.001) and APACHE II score (16 vs. 22, P=0.041) were significantly lower in the in-hospital survival group. Multivariate Logistic regression analysis showed that PaO 2/FiO 2( OR=1.015, P=0.044), MP ( OR=1.813, P=0.039) and SOFA score( OR=2.651, P=0.010) were independent risk factors for predicting hospital mortality in patients with mechanical ventilation. The areas under the ROC curves (AUC) were 0.62, 0.63 and 0.75, respectively. Moreover, the MP combined with SOFA score for predicting in-hospital death was significantly higher than that of MP alone (0.77 vs. 0.63, P<0.05). Conclusions:MP is associated with in-hospital death in patients with invasive mechanical ventilation in emergency department. MP combined with SOFA score can enhance its predictive efficacy
