Characteristics and Outcomes in Adult Patients Receiving Mechanical Ventilation: A 28-Day International Study

CONTEXT The outcome of patients receiving mechanical ventilation for particular indications has been studied, but the outcome in a large number of unselected, heterogeneous patients has not been reported. OBJECTIVE To determine the survival of patients receiving mechanical ventilation and the relati...

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Published in:JAMA : the journal of the American Medical Association 2002-01, Vol.287 (3), p.345-355
Main Authors: Esteban, Andrés, Anzueto, Antonio, Frutos, Fernando, Alía, Inmaculada, Brochard, Laurent, Stewart, Thomas E, Benito, Salvador, Epstein, Scott K, Apezteguía, Carlos, Nightingale, Peter, Arroliga, Alejandro C, Tobin, Martin J, for the Mechanical Ventilation International Study Group
Format: Article
Language:English
Subjects:
Adult
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Cause of Death
Clinical outcomes
Emergency and intensive respiratory care
Female
Hospital Mortality
Humans
Intensive care medicine
Intensive Care Units
Life support systems
Logistic Models
Male
Medical sciences
Middle Aged
Mortality
Multiple Organ Failure
Outcome Assessment (Health Care)
Proportional Hazards Models
Prospective Studies
Pulmonary Disease, Chronic Obstructive - therapy
Respiration, Artificial - mortality
Respiratory Distress Syndrome, Adult - therapy
Survival Analysis
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Summary:CONTEXT The outcome of patients receiving mechanical ventilation for particular indications has been studied, but the outcome in a large number of unselected, heterogeneous patients has not been reported. OBJECTIVE To determine the survival of patients receiving mechanical ventilation and the relative importance of factors influencing survival. DESIGN, SETTING, AND SUBJECTS Prospective cohort of consecutive adult patients admitted to 361 intensive care units who received mechanical ventilation for more than 12 hours between March 1, 1998, and March 31, 1998. Data were collected on each patient at initiation of mechanical ventilation and daily throughout the course of mechanical ventilation for up to 28 days. MAIN OUTCOME MEASURE All-cause mortality during intensive care unit stay. RESULTS Of the 15 757 patients admitted, a total of 5183 (33%) received mechanical ventilation for a mean (SD) duration of 5.9 (7.2) days. The mean (SD) length of stay in the intensive care unit was 11.2 (13.7) days. Overall mortality rate in the intensive care unit was 30.7% (1590 patients) for the entire population, 52% (120) in patients who received ventilation because of acute respiratory distress syndrome, and 22% (115) in patients who received ventilation for an exacerbation of chronic obstructive pulmonary disease. Survival of unselected patients receiving mechanical ventilation for more than 12 hours was 69%. The main conditions independently associated with increased mortality were (1) factors present at the start of mechanical ventilation (odds ratio [OR], 2.98; 95% confidence interval [CI], 2.44-3.63; P
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.287.3.345