Age, duration of mechanical ventilation, and outcomes of patients who are critically ill.
BACKGROUND
Age and duration of mechanical ventilation (MV) are strongly associated with mortality and hospital discharge disposition.


METHODS
Electronic administrative records from a 425-bed community teaching hospital were obtained for 9,912 patients who were admitted to hospital ICUs between 2003 and 2008. Risk estimates of age and duration of MV for in-hospital mortality and discharge to home vs extended-care facilities (ECFs) also were obtained.


RESULTS
Of 9,912 patients, 37 were discharged to hospice care, and 668 were < 18 years of age. Of the remaining 9,207 patients, 4,238 received invasive MV. Mortality or hospital discharge to ECFs increased consistently for each decade of age > 65 years and as the duration of MV increased. Although only 11.7% of patients < 65 years age who received MV for 1 or 2 days died during hospitalization, the mortality rate increased to 72.1% for patients > 85 years of age who had received MV for > 7 days. For patients requiring MV for >or= 7 days, < 10% of the >or= 65 years of age and < 5% of patients >or= 85 years of age survived to be discharged home from the hospital. Multivariate logistic regression analyses showed that age > 65 years and duration of MV remained significantly associated with outcomes, even after adjustment for hospital discharge diagnoses (Charlson scores).


CONCLUSIONS
This study suggests that age and duration of MV are strongly associated with mortality and posthospital disposition. If confirmed, the simple combination of age and duration of MV provides prognostic information that could be used with trajectory of illness and in the context of patients' values to inform end-of-life discussions with patients or their surrogates during a trial of critical care.
Feng
Yan
Y
Bridgeport Hospital, Bridgeport, CT; Yale University School of Medicine, New Haven, CT.
Amoateng-Adjepong
Yaw
Y
Bridgeport Hospital, Bridgeport, CT; Yale University School of Medicine, New Haven, CT.
Kaufman
David
D
Bridgeport Hospital, Bridgeport, CT; Yale University School of Medicine, New Haven, CT.
Gheorghe
Cristina
C
Bridgeport Hospital, Bridgeport, CT; Yale University School of Medicine, New Haven, CT.
Manthous
Constantine A
CA
Bridgeport Hospital, Bridgeport, CT; Yale University School of Medicine, New Haven, CT. Electronic address: Pcmant@bpthosp.org.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D015897:Comorbidity; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D011379:Prognosis; D012121:Respiration, Artificial / Q000401:mortality*; D018709:Statistics, Nonparametric; D013997:Time Factors