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KMID : 0383820080650040292
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Tuberculosis and Respiratory Diseases
2008 Volume.65 No. 4 p.292 ~ p.300
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Analysis of Characteristics and Prognostic Factors in Adult Patients Receiving Mechanical Ventilation in the Medical Intensive Care Unit of a University Hospital
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Song Jin-Woo
Choi Chang-Min
Hong Sang-Bum
Oh Yeon-Mok
Shim Tae-Sun
Lim Chae-Man
Lee Sang-Do
Kim Woo-Sung
Kim Dong-Soon
Kim Won-Dong
Koh Youn-Suck
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Abstract
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Background: Respiratory failure is a common condition that requires intensive care, and has a high mortality rate
despite the recent improvements in respiratory care. Previous reports of patients with respiratory failure focused on the specific disease or included a large proportion of surgical patients. This study evaluated the clinical characteristics, outcomes and prognostic factors of adult patients receiving mechanical ventilation in a medical intensive care unit.
Methods: Retrospective chart review was performed on 479 adult patients, who received mechanical ventilation
for more than 48 hours in the medical ICU of one tertiary referral hospital.
Results: The mean age of the patients was 60.3±15.6 years and 34.0% were female. The initial mean APACHE
III score was 72.3±25. The cause of MV included acute respiratory failure (71.8%), acute exacerbation of chronic
pulmonary disease (20.9%), coma (5.6%), and neuromuscular disorders (1.7%). Pressure controlled ventilation was used as the initial ventilator mode in 67.8% of patients, and pressure support ventilation was used as the initial weaning mode in 83.6% of the patients. The overall mortality rate in the ICU and hospital was 49.3% and 55.4%, respectively. The main cause of death in hospital was septic shock (32.5%), respiratory failure (11.7%), and multiorgan failure (10.2%). Males, an APACHE III score ＞70, the cause of respiratory failure (interstitial lung disease, coma, aspiration, pneumonia, sepsis and hemoptysis), the total ventilation time, and length of stay in hospital were independently associated with mortality.
Conclusion: The cause of respiratory failure, severity of the patients, and gender appears to be significantly
associated with the outcome of mechanical ventilatory support in patients with respiratory failure.
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KEYWORD
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Respiratory failure, Mechanical ventilation, Outcome, Prognostic factor
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