Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Prognostic Factors of Patients Requiring Prolonged Mechanical Ventilation in a Medical Intensive Care Unit of Korea

  • Kim, Mi Hyun (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Cho, Woo Hyun (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Lee, Kwangha (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Kim, Ki Uk (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Jeon, Doo Soo (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Park, Hye-Kyung (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Kim, Yun Seong (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Lee, Min Ki (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Park, Soon Kew (Department of Internal Medicine, Pusan National University School of Medicine)
  • Received : 2012.06.18
  • Accepted : 2012.09.27
  • Published : 2012.10.30
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Abstract

Background: We evaluated the clinical outcomes and prognostic factors of patients requiring prolonged mechanical ventilation (PMV), defined as ventilator care for ${\geq}21$ days, who were admitted to the medical intensive care unit (ICU) of a university hospital in Korea. Methods: During the study period, a total of 2,644 patients were admitted to the medical ICU, and 136 patients (5.1%) were enrolled between 2005 and 2010. Results: The mean age of the patients was $61.3{\pm}14.5$ years, and 94 (69.1%) were male. The ICU and six-month cumulative mortality rates were 45.6 and 58.8%, respectively. There were 96 patients with tracheostomy placement after admission and their mean period from admission to the day of tracheostomy was $21.3{\pm}8.4$ days. Sixty-three patients (46.3%) were successfully weaned from ventilator care. Of the ICU survivors (n=74), 34 patients (45.9%) were transferred to other hospitals (not university hospitals). Two variables (thrombocytopenia [hazard ratio (HR), 1.964; 95% confidence interval (CI), 1.225~3.148; p=0.005] and the requirement for vasopressors [HR, 1.822; 95% CI, 1.111~2.986; p=0.017] on day 21) were found to be independent factors of survival on based on the Cox proportional hazard model. Conclusion: We found that patients requiring PMV had high six-month cumulative mortality rates, and that two clinical variables (measured on day 21), thrombocytopenia and requirement for vasopressors, may be associated with prognostic indicators.

Keywords

Acknowledgement

Supported by : Pusan National University Hospital

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