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KMID : 0383820120730040224
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Tuberculosis and Respiratory Diseases
2012 Volume.73 No. 4 p.224 ~ p.230
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Prognostic Factors of Patients Requiring Prolonged Mechanical Ventilation in a Medical Intensive Care Unit of Korea
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Kim Mi-Hyun
Cho Woo-Hyun
Lee Kwang-Ha
Kim Ki-Uk
Jeon Doo-Soo
Park Hye-Kyung
Kim Yun-Seong
Lee Min-Ki
Park Soon-Kew
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Abstract
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Background: We evaluated the clinical outcomes and prognostic factors of patients requiring prolonged mechanical ventilation (PMV), defined as ventilator care for ≥21 days, who were admitted to the medical intensive care unit (ICU) of a university hospital in Korea.
Materials and 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.
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KEYWORD
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Ventilators, Mechanical, Intensive Care Units, Korea
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