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Research article
Predictors of 1-year mortality in patients on prolonged mechanical ventilation after surgery in intensive care unit: a multicenter, retrospective cohort study
Shuangling Li
Peking University First Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4292-8208
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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.
Keywords
Intensive care unit; Prolonged mechanical ventilation; Postoperative patients; 1-year mortality
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Received 06 Jan, 2020
Editor assigned
On 03 Jan, 2020
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Invitations sent on 03 Jan, 2020
Reviewer #1 agreed
On 03 Jan, 2020
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On 02 Jan, 2020
Editor invited
On 02 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 21 Dec, 2019
Review #1 received
Received 20 Dec, 2019
Reviewer #3 agreed
On 13 Dec, 2019
Review #3 received
Received 13 Dec, 2019
Review #2 received
Received 13 Dec, 2019
Reviewer #2 agreed
On 12 Dec, 2019
Reviewers invited
Invitations sent on 10 Dec, 2019
Reviewer #1 agreed
On 10 Dec, 2019
Editor assigned
On 09 Dec, 2019
Submission checks complete
On 08 Dec, 2019
Editor invited
On 08 Dec, 2019
No comments provided
Review #3 received
Received 20 Nov, 2019
Editorial decision: Major revision
On 20 Nov, 2019
Review #2 received
Received 11 Nov, 2019
Review #1 received
Received 10 Nov, 2019
Reviewer #3 agreed
On 03 Nov, 2019
Reviewer #2 agreed
On 03 Nov, 2019
Reviewer #1 agreed
On 29 Oct, 2019
Reviewers invited
Invitations sent on 25 Oct, 2019
Submission checks complete
On 21 Oct, 2019
Editor assigned
On 15 Oct, 2019
Editor invited
On 14 Oct, 2019
First submitted
On 10 Oct, 2019
Metrics
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Subject Areas
Anesthesiology & Pain Medicine
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This preprint is under consideration at BMC Anesthesiology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Predictors of 1-year mortality in patients on prolonged mechanical ventilation after surgery in intensive care unit: a multicenter, retrospective cohort study
Shuangling Li
Peking University First Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4292-8208
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 3
Posted 07 Jan, 2020
No community comments so far
Review #2 received
Received 15 Jan, 2020
Reviewer #2 agreed
On 06 Jan, 2020
Review #1 received
Received 06 Jan, 2020
Editor assigned
On 03 Jan, 2020
Reviewers invited
Invitations sent on 03 Jan, 2020
Reviewer #1 agreed
On 03 Jan, 2020
Submission checks complete
On 02 Jan, 2020
Editor invited
On 02 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 21 Dec, 2019
Review #1 received
Received 20 Dec, 2019
Reviewer #3 agreed
On 13 Dec, 2019
Review #3 received
Received 13 Dec, 2019
Review #2 received
Received 13 Dec, 2019
Reviewer #2 agreed
On 12 Dec, 2019
Reviewers invited
Invitations sent on 10 Dec, 2019
Reviewer #1 agreed
On 10 Dec, 2019
Editor assigned
On 09 Dec, 2019
Submission checks complete
On 08 Dec, 2019
Editor invited
On 08 Dec, 2019
No comments provided
Review #3 received
Received 20 Nov, 2019
Editorial decision: Major revision
On 20 Nov, 2019
Review #2 received
Received 11 Nov, 2019
Review #1 received
Received 10 Nov, 2019
Reviewer #3 agreed
On 03 Nov, 2019
Reviewer #2 agreed
On 03 Nov, 2019
Reviewer #1 agreed
On 29 Oct, 2019
Reviewers invited
Invitations sent on 25 Oct, 2019
Submission checks complete
On 21 Oct, 2019
Editor assigned
On 15 Oct, 2019
Editor invited
On 14 Oct, 2019
First submitted
On 10 Oct, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Anesthesiology & Pain Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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