Acute respiratory failure prognosis in prolonged ICU stays

Abstract

Objective: This study aimed to assess the outcome of patients with acute respiratory failure and need of mechanical ventilation who stayed for more than 21 days in the ICU. Methods: All acute respiratory failure patients in King Saud Medical City, Riyadh Saudi Arabia and adults ICU who required a lengthy intensive care unit stay of more than 21 days between January 2022 and August 2023 were identified in this retrospective study. Information was extracted from the hospital database by trained physicians. Results: Total 121 patients (mean age 61.2±15.8 years) were included. Of which, 24.1% patients were more than 70 years. Sepsis was the most common cause of prolonged ICU stay both in survivors and non-survivors with 77.8% and 76.1%, respectively. Compared to patients who survived, non-survivors had higher acute physiology and chronic health evaluation (APACHE 4) scores were considerably older. Moreover, non-survivors were more likely than survivors to have renal failure, arrhythmia, hepatic failure, or significant gastrointestinal tract bleeding as reasons for a lengthy ICU stay. Patients who were admitted to ICU because they needed further surgery were more likely to survive. Conclusion: When acute respiratory fever (ARF) patients needed a lengthy stay in the ICU, their prognosis was not good. A high risk of in-hospital death was linked to older ages, more than 28 days ICU stay, more than 25 APACHE 4 score, unstable hemodynamic condition, hepatic failure, renal failure, major gastrointestinal tract bleeding, and needing FiO2 ≥40%.