Prognostic Factors of Patients Requiring Prolonged Mechanical Ventilation in a Medical Intensive Care Unit of Korea.
10.4046/trd.2012.73.4.224
- Author:
Mi Hyun KIM
1
;
Woo Hyun CHO
;
Kwangha LEE
;
Ki Uk KIM
;
Doo Soo JEON
;
Hye Kyung PARK
;
Yun Seong KIM
;
Min Ki LEE
;
Soon Kew PARK
Author Information
1. Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea. jubilate@pusan.ac.kr
- Publication Type:Original Article
- Keywords:
Ventilators, Mechanical;
Intensive Care Units;
Korea
- MeSH:
Humans;
Critical Care;
Intensive Care Units;
Korea;
Male;
Respiration, Artificial;
Survivors;
Thrombocytopenia;
Tracheostomy;
Ventilators, Mechanical
- From:Tuberculosis and Respiratory Diseases
2012;73(4):224-230
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: We evaluated the clinical outcomes and prognostic factors of patients requiring prolonged mechanical ventilation (PMV), defined as ventilator care for > or =21 days, who were admitted to the medical intensive care unit (ICU) of a university hospital in Korea. METHODS: During the study period, a total of 2,644 patients were admitted to the medical ICU, and 136 patients (5.1%) were enrolled between 2005 and 2010. RESULTS: The mean age of the patients was 61.3+/-14.5 years, and 94 (69.1%) were male. The ICU and six-month cumulative mortality rates were 45.6 and 58.8%, respectively. There were 96 patients with tracheostomy placement after admission and their mean period from admission to the day of tracheostomy was 21.3+/-8.4 days. Sixty-three patients (46.3%) were successfully weaned from ventilator care. Of the ICU survivors (n=74), 34 patients (45.9%) were transferred to other hospitals (not university hospitals). Two variables (thrombocytopenia [hazard ratio (HR), 1.964; 95% confidence interval (CI), 1.225~3.148; p=0.005] and the requirement for vasopressors [HR, 1.822; 95% CI, 1.111~2.986; p=0.017] on day 21) were found to be independent factors of survival on based on the Cox proportional hazard model. CONCLUSION: We found that patients requiring PMV had high six-month cumulative mortality rates, and that two clinical variables (measured on day 21), thrombocytopenia and requirement for vasopressors, may be associated with prognostic indicators.
