Factors Associated with Survival in Patients Undergoing Invasive Mechanical Ventilation in an Intensive Care Unit in Colombia, 2017-2018: A Retrospective Cohort Study.

Abstract

BackgroundCritically ill patients are admitted to intensive care units so they can be comprehensively managed and provided with services not covered in general hospital wards, with the aim to increase their chances of survival. These procedures include invasive mechanical ventilation.ObjectiveThe aim of this study was to identify the factors associated with survival in critically ill patients who required invasive mechanical ventilation in an intensive care unit of a tertiary-level hospital in Colombia.MethodsThis was a retrospective follow-up study of a cohort of adult patients who required invasive mechanical ventilation in an intensive care unit in San José de Buga Hospital, between 2017 and 2018. Sociodemographic, clinical, and pharmacological variables were identified. Using Cox regression, variables associated with survival and complications were identified.ResultsA total of 357 patients were analyzed. The average age was 64.8 ± 18.9 years, and 52.9% were male. The most frequent diagnoses were sepsis/septic shock (38.4%) and trauma (17.4%). The main factors associated with shorter survival were advanced age (HR 0.97; 95% CI 0.96–0.99), a diagnosis of septic shock (HR 0.29; 95% CI 0.18–0.48) or diabetes mellitus at admission (HR 0.57; 95% CI 0.33–0.98), a healthcare-associated infection (HR 0.51; 95% CI 0.33–0.80), and the need for vasopressors (HR 0.36; 95% CI 0.22–0.59). The administration of systemic corticosteroids was associated with a higher probability of survival (HR 1.93; 95% CI 1.15–3.25).ConclusionsThe use of systemic corticosteroids was associated with a greater probability of survival in critically ill patients who required invasive mechanical ventilation in an intensive care unit. The identification of the variables associated with a higher risk of dying should allow care protocols to be improved, thereby extending the life expectancy of these patients.