Predictors of 1-year mortality in patients on prolonged mechanical ventilation after surgery in intensive care unit: a multicenter, retrospective cohort study
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.
Design: Multicenter, retrospective cohort study
Setting: ICUs at 5 tertiary hospitals in Beijing
Participants: Patients who required PMV after surgery between January 2007 and June 2016 were enrolled.
Interventions: None
Measurements and Main 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 9 /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 21 st day of mechanical ventilation 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 9 /L, vasopressor requirement, and renal replacement therapy on the 21 st day of mechanical ventilation 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.
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Posted 07 Jan, 2020
Received 15 Jan, 2020
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On 21 Oct, 2019
On 15 Oct, 2019
On 14 Oct, 2019
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Predictors of 1-year mortality in patients on prolonged mechanical ventilation after surgery in intensive care unit: a multicenter, retrospective cohort study
Posted 07 Jan, 2020
Received 15 Jan, 2020
On 06 Jan, 2020
Received 06 Jan, 2020
On 03 Jan, 2020
Invitations sent on 03 Jan, 2020
On 03 Jan, 2020
On 02 Jan, 2020
On 02 Jan, 2020
On 21 Dec, 2019
Received 20 Dec, 2019
On 13 Dec, 2019
Received 13 Dec, 2019
Received 13 Dec, 2019
On 12 Dec, 2019
Invitations sent on 10 Dec, 2019
On 10 Dec, 2019
On 09 Dec, 2019
On 08 Dec, 2019
On 08 Dec, 2019
Received 20 Nov, 2019
On 20 Nov, 2019
Received 11 Nov, 2019
Received 10 Nov, 2019
On 03 Nov, 2019
On 03 Nov, 2019
On 29 Oct, 2019
Invitations sent on 25 Oct, 2019
On 21 Oct, 2019
On 15 Oct, 2019
On 14 Oct, 2019
On 10 Oct, 2019
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.
Design: Multicenter, retrospective cohort study
Setting: ICUs at 5 tertiary hospitals in Beijing
Participants: Patients who required PMV after surgery between January 2007 and June 2016 were enrolled.
Interventions: None
Measurements and Main 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 9 /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 21 st day of mechanical ventilation 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 9 /L, vasopressor requirement, and renal replacement therapy on the 21 st day of mechanical ventilation 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.
Figure 1
Figure 2