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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 |
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| creator | 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 |
| description | 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 |
| doi_str_mv | 10.1001/jama.287.3.345 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_71395658</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ama_id>194560</ama_id><sourcerecordid>71395658</sourcerecordid><originalsourceid>FETCH-LOGICAL-a322t-c8a12afcf8d83f86e6f036a295a77c99b5f37c972fad9a12e7f7a8166bfb4d433</originalsourceid><addsrcrecordid>eNpd0d9LHDEQB_AgLb3z2teCLyUI9m2v-bWbxLfj1HqgKK32dZnLJl6O3axussL99wY9ETovAzMfhvANQt8pmVNC6K8tdDBnSs75nIvyAE1pyVXBS60-oSkhWhVSKDFBhzFuSS7K5Rc0oVRqwqiYom65gQFMsoOPyZuIITT4Zkym72zEPuBFM7YJ30LyNqSI_1hj_bMPD_jamg0Eb6DF__LKt5n04RQvMFPFGezwKuSr4XWazd80Nruv6LODNtpv-z5D9xfnd8vL4urm92q5uCqAM5YKo4AycMapRnGnKls5witgugQpjdbr0vHcJXPQ6EytdBIUraq1W4tGcD5DP9_uPg7902hjqjsfjW1bCLYfYy0p12VVqgyP_4PbfsyPbmPNaM5KCMUy-rFH47qzTf04-A6GXf2eYgYnewAx5-EGCMbHD8eFqBQj2R29ufxpH1styorwFzzfiW8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211374482</pqid></control><display><type>article</type><title>Characteristics and Outcomes in Adult Patients Receiving Mechanical Ventilation: A 28-Day International Study</title><source>AMA Current Titles</source><creator>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</creator><creatorcontrib>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 ; Mechanical Ventilation International Study Group</creatorcontrib><description>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<.001 for coma), (2) factors related to patient management (OR,
3.67; 95% CI, 2.02-6.66; P<.001 for plateau airway
pressure >35 cm H2O), and (3) developments occurring over the course
of mechanical ventilation (OR, 8.71; 95% CI, 5.44-13.94; P<.001 for ratio of PaO2 to fraction of inspired oxygen
<100). CONCLUSION Survival among mechanically ventilated patients depends not only on
the factors present at the start of mechanical ventilation, but also on the
development of complications and patient management in the intensive care
unit.</description><identifier>ISSN: 0098-7484</identifier><identifier>EISSN: 1538-3598</identifier><identifier>DOI: 10.1001/jama.287.3.345</identifier><identifier>PMID: 11790214</identifier><identifier>CODEN: JAMAAP</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>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</subject><ispartof>JAMA : the journal of the American Medical Association, 2002-01, Vol.287 (3), p.345-355</ispartof><rights>2002 INIST-CNRS</rights><rights>Copyright American Medical Association Jan 16, 2002</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13446820$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11790214$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Esteban, Andrés</creatorcontrib><creatorcontrib>Anzueto, Antonio</creatorcontrib><creatorcontrib>Frutos, Fernando</creatorcontrib><creatorcontrib>Alía, Inmaculada</creatorcontrib><creatorcontrib>Brochard, Laurent</creatorcontrib><creatorcontrib>Stewart, Thomas E</creatorcontrib><creatorcontrib>Benito, Salvador</creatorcontrib><creatorcontrib>Epstein, Scott K</creatorcontrib><creatorcontrib>Apezteguía, Carlos</creatorcontrib><creatorcontrib>Nightingale, Peter</creatorcontrib><creatorcontrib>Arroliga, Alejandro C</creatorcontrib><creatorcontrib>Tobin, Martin J</creatorcontrib><creatorcontrib>for the Mechanical Ventilation International Study Group</creatorcontrib><creatorcontrib>Mechanical Ventilation International Study Group</creatorcontrib><title>Characteristics and Outcomes in Adult Patients Receiving Mechanical Ventilation: A 28-Day International Study</title><title>JAMA : the journal of the American Medical Association</title><addtitle>JAMA</addtitle><description>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<.001 for coma), (2) factors related to patient management (OR,
3.67; 95% CI, 2.02-6.66; P<.001 for plateau airway
pressure >35 cm H2O), and (3) developments occurring over the course
of mechanical ventilation (OR, 8.71; 95% CI, 5.44-13.94; P<.001 for ratio of PaO2 to fraction of inspired oxygen
<100). CONCLUSION Survival among mechanically ventilated patients depends not only on
the factors present at the start of mechanical ventilation, but also on the
development of complications and patient management in the intensive care
unit.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cause of Death</subject><subject>Clinical outcomes</subject><subject>Emergency and intensive respiratory care</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Intensive Care Units</subject><subject>Life support systems</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multiple Organ Failure</subject><subject>Outcome Assessment (Health Care)</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Pulmonary Disease, Chronic Obstructive - therapy</subject><subject>Respiration, Artificial - mortality</subject><subject>Respiratory Distress Syndrome, Adult - therapy</subject><subject>Survival Analysis</subject><issn>0098-7484</issn><issn>1538-3598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><recordid>eNpd0d9LHDEQB_AgLb3z2teCLyUI9m2v-bWbxLfj1HqgKK32dZnLJl6O3axussL99wY9ETovAzMfhvANQt8pmVNC6K8tdDBnSs75nIvyAE1pyVXBS60-oSkhWhVSKDFBhzFuSS7K5Rc0oVRqwqiYom65gQFMsoOPyZuIITT4Zkym72zEPuBFM7YJ30LyNqSI_1hj_bMPD_jamg0Eb6DF__LKt5n04RQvMFPFGezwKuSr4XWazd80Nruv6LODNtpv-z5D9xfnd8vL4urm92q5uCqAM5YKo4AycMapRnGnKls5witgugQpjdbr0vHcJXPQ6EytdBIUraq1W4tGcD5DP9_uPg7902hjqjsfjW1bCLYfYy0p12VVqgyP_4PbfsyPbmPNaM5KCMUy-rFH47qzTf04-A6GXf2eYgYnewAx5-EGCMbHD8eFqBQj2R29ufxpH1styorwFzzfiW8</recordid><startdate>20020116</startdate><enddate>20020116</enddate><creator>Esteban, Andrés</creator><creator>Anzueto, Antonio</creator><creator>Frutos, Fernando</creator><creator>Alía, Inmaculada</creator><creator>Brochard, Laurent</creator><creator>Stewart, Thomas E</creator><creator>Benito, Salvador</creator><creator>Epstein, Scott K</creator><creator>Apezteguía, Carlos</creator><creator>Nightingale, Peter</creator><creator>Arroliga, Alejandro C</creator><creator>Tobin, Martin J</creator><creator>for the Mechanical Ventilation International Study Group</creator><general>American Medical Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QL</scope><scope>7QP</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20020116</creationdate><title>Characteristics and Outcomes in Adult Patients Receiving Mechanical Ventilation: A 28-Day International Study</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a322t-c8a12afcf8d83f86e6f036a295a77c99b5f37c972fad9a12e7f7a8166bfb4d433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cause of Death</topic><topic>Clinical outcomes</topic><topic>Emergency and intensive respiratory care</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Intensive Care Units</topic><topic>Life support systems</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multiple Organ Failure</topic><topic>Outcome Assessment (Health Care)</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Pulmonary Disease, Chronic Obstructive - therapy</topic><topic>Respiration, Artificial - mortality</topic><topic>Respiratory Distress Syndrome, Adult - therapy</topic><topic>Survival Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Esteban, Andrés</creatorcontrib><creatorcontrib>Anzueto, Antonio</creatorcontrib><creatorcontrib>Frutos, Fernando</creatorcontrib><creatorcontrib>Alía, Inmaculada</creatorcontrib><creatorcontrib>Brochard, Laurent</creatorcontrib><creatorcontrib>Stewart, Thomas E</creatorcontrib><creatorcontrib>Benito, Salvador</creatorcontrib><creatorcontrib>Epstein, Scott K</creatorcontrib><creatorcontrib>Apezteguía, Carlos</creatorcontrib><creatorcontrib>Nightingale, Peter</creatorcontrib><creatorcontrib>Arroliga, Alejandro C</creatorcontrib><creatorcontrib>Tobin, Martin J</creatorcontrib><creatorcontrib>for the Mechanical Ventilation International Study Group</creatorcontrib><creatorcontrib>Mechanical Ventilation International Study Group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>JAMA : the journal of the American Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Esteban, Andrés</au><au>Anzueto, Antonio</au><au>Frutos, Fernando</au><au>Alía, Inmaculada</au><au>Brochard, Laurent</au><au>Stewart, Thomas E</au><au>Benito, Salvador</au><au>Epstein, Scott K</au><au>Apezteguía, Carlos</au><au>Nightingale, Peter</au><au>Arroliga, Alejandro C</au><au>Tobin, Martin J</au><au>for the Mechanical Ventilation International Study Group</au><aucorp>Mechanical Ventilation International Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Characteristics and Outcomes in Adult Patients Receiving Mechanical Ventilation: A 28-Day International Study</atitle><jtitle>JAMA : the journal of the American Medical Association</jtitle><addtitle>JAMA</addtitle><date>2002-01-16</date><risdate>2002</risdate><volume>287</volume><issue>3</issue><spage>345</spage><epage>355</epage><pages>345-355</pages><issn>0098-7484</issn><eissn>1538-3598</eissn><coden>JAMAAP</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>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<.001 for coma), (2) factors related to patient management (OR,
3.67; 95% CI, 2.02-6.66; P<.001 for plateau airway
pressure >35 cm H2O), and (3) developments occurring over the course
of mechanical ventilation (OR, 8.71; 95% CI, 5.44-13.94; P<.001 for ratio of PaO2 to fraction of inspired oxygen
<100). CONCLUSION Survival among mechanically ventilated patients depends not only on
the factors present at the start of mechanical ventilation, but also on the
development of complications and patient management in the intensive care
unit.</abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>11790214</pmid><doi>10.1001/jama.287.3.345</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0098-7484 |
| ispartof | JAMA : the journal of the American Medical Association, 2002-01, Vol.287 (3), p.345-355 |
| issn | 0098-7484 1538-3598 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_71395658 |
| source | AMA Current Titles |
| 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 |
| title | Characteristics and Outcomes in Adult Patients Receiving Mechanical Ventilation: A 28-Day International Study |
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