Abstract
The possible factors affecting hospital mortality among mechanically ventilated patients in respiratory ICU is still not fully studied. The aim of this study was to identify the predictors of hospital mortality among mechanically ventilated patients in respiratory ICU. In a prospective descriptive study, all eligible patients of Assiut Chest Department who were mechanically ventilated for more than 1 day (247 patients) during the period from April 2010 to March 2012 were included in this study. Different clinical and laboratory variables were recorded at the time of admission and followed until hospital discharge and were compared between survivors (146 patients) and nonsurvivors (101 patients). A total of 247 patients were included in the study. The mean age was 57.6 ± 13.3 years. Male patients represented 65.6% of the study cohort. The hospital mortality was 40.9%. On multivariate analysis, risk factors for hospital mortality were as follows: patients diagnosed with adult respiratory distress syndrome, interstitial lung diseases, and pulmonary embolism [odds ratio (OR) = 14.2 95% confidence interval (CI), P = 0.031]; hospital complications (OR = 9.17 95% CI, P = 0.000); reintubation (OR = 8.56 95% CI, P = 0.000); use of sedatives for 24 h or more (OR = 3.72 95% CI, P = 0.04); and comorbidity burden (OR = 2.36 95% CI, P = 0.006). The major independent risk factor for hospital mortality was patients diagnosed with adult respiratory distress syndrome, interstitial lung diseases, and pulmonary embolism. In addition, patients suffering from more comorbidities or hospital complications and patients requiring longer use of sedation (≥24 h) should be monitored closely in ICU because of their high risk for hospital nonsurvival. Egypt J Broncho 2015 9:231–237
Highlights
Mechanical ventilation (MV) is an essential life support for the survival of a significant percentage of patients admitted to the ICUs
Multivariate logistic regression identified patients diagnosed with adult respiratory distress syndrome (ARDS),interstitial lung diseases (ILDs), Table 4 Length of stay, duration of MV, and outcome
The present study included 148 patients diagnosed with chronic obstructive pulmonary disease (COPD) (59.9%); 47 patients suffered from chronic respiratory failure other than COPD (20.1%) and 52 patients from acute respiratory failure (19%)
Summary
Mechanical ventilation (MV) is an essential life support for the survival of a significant percentage of patients admitted to the ICUs. Patients admitted in the ICUs in the developing world are substantially different from those in developed countries [1]. Mortality associated with MV has been amply described, with widely varied results. Mortality may be set at around 40%, it depends on different factors [2].The aim of the clinical practice is to decrease the mortality rate in ICUs. Determination of the risk factors for mortality may provide useful guidance for intensive care patients. Predicting outcomes is an important issue during the management of critically ill patients [3]. The possible factors affecting hospital mortality among mechanically ventilated patients in respiratory ICU is still not fully studied
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