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Prognosis of mechanically ventilated patients.

Authors
  • Papadakis, M A
  • Lee, K K
  • Browner, W S
  • Kent, D L
  • Matchar, D B
  • Kagawa, M K
  • Hallenbeck, J
  • Lee, D
  • Onishi, R
  • Charles, G
Type
Published Article
Journal
Western Journal of Medicine
Publisher
BMJ
Publication Date
Dec 01, 1993
Volume
159
Issue
6
Pages
659–664
Identifiers
PMID: 8128673
Source
Medline
License
Unknown

Abstract

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.

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