Mortality study in patients at weaning from mechanical ventilation

Abstract

ObjectiveTo explain mortality in the ICU and in hospital among patients subjected to invasive mechanical ventilation. DesignA prospective, 9-month observational cohort study was carried out. SettingA Department of Intensive Care Medicine. PatientsConsecutive patients requiring invasive mechanical ventilation were followed-up on until hospital discharge or death. InterventionsNone. Interest variablesDate of admission, day of first spontaneous breathing test, length of mechanical ventilation, final extubation date, days in ICU, days in hospital or discharge from ICU, SAPS 3 score, WIND study classification, day of death, hospital discharge. Measurements and main resultsThere were 266 patients: 40 in group 0 of the WIND classification, 15% 95%CI (11-20%); 166 in group 1, 62% 95%CI (56-68%); 38 in group 2, 14% 95%CI (11-19%); and 22 in group 3, 8% 95%CI (6-12%). Logistic regression analysis showed group 3 to have the highest hospital mortality (group 3 vs group 1; OR 4.0 95%CI (1.5–10.8)). However, Cox regression analysis showed no significant differences (HR group 3 vs group 1, 1.6 95%CI (0.7–3.4), p = ns). ConclusionsIn our study, considering exposure time, the probability of mortality was the same among the three different groups of patients with at least one spontaneous breathing test.