Prognosis of mechanically ventilated patients.

Journal Article

In this Department of Veterans Affairs cooperative study, we examined predictors of in-hospital and 1-year mortality of 612 mechanically ventilated patients from 6 medical intensive care units in a retrospective cohort design. The outcome variable was vital status at hospital discharge and after 1 year. The results showed that 97% of patients were men, the mean age was 63 +/- 11 years (SD), and hospital mortality was 64% (95% confidence interval, 60% to 68%). Within the next year, an additional 38% of hospital survivors died, for a total 1-year mortality of 77% (95% confidence interval, 73% to 80%). Hospital and 1-year mortality, respectively, for patients older than 70 years was 76% and 94%, for those with serum albumin levels below 20 grams per liter it was 92% and 96%, for those with an Acute Physiology and Chronic Health Evaluation II (APACHE II) score greater than 35 it was 91% and 98%, and for patients who were being mechanically ventilated after cardiopulmonary resuscitation it was 86% and 90%. The mortality ratio (actual mortality versus APACHE II-predicted mortality) was 1.15. Conclusions are that patient age, APACHE II score, serum albumin levels, or the use of cardiopulmonary resuscitation may identify a subset of mechanically ventilated veterans for whom mechanical ventilation provides little or no benefit.

Full Text

Duke Authors

Cited Authors

  • Papadakis, MA; Lee, KK; Browner, WS; Kent, DL; Matchar, DB; Kagawa, MK; Hallenbeck, J; Lee, D; Onishi, R; Charles, G

Published Date

  • December 1993

Published In

Volume / Issue

  • 159 / 6

Start / End Page

  • 659 - 664

PubMed ID

  • 8128673

International Standard Serial Number (ISSN)

  • 0093-0415

Language

  • eng

Conference Location

  • United States