title: Reinstitution of mechanical ventilation within 14 days as a poor predictor in prolonged mechanical ventilation patients following successful weaning.
abstract: Although many parameters were investigated about weaning and mortality in critical patients in intensive units, no studies have yet investigated predictors in prolonged mechanical ventilation (PMV) patients following successful weaning. A cohort of 142 consecutive PMV patients with successful weaning in our respiratory care center was enrolled in this study. Successful weaning is defined as a patient having smooth respiration for more than 5 days after weaning. The results showed as follows: twenty-seven patients (19%) had the reinstitution within 14 days, and 115 patients (81%) had the reinstitution beyond 14 days. Renal disease RIFLE-LE was associated with the reinstitution within 14 days (P = 0.006). One year mortality rates showed significant difference between the two groups (85.2% in the reinstitution within 14 days group versus 53.1% in the reinstitution beyond 14 days; P < 0.001). Kaplan-Meier analysis showed that age ≥70 years (P = 0.04), ESRD (P = 0.02), and the reinstitution within 14 days (P < 0.001) were associated with one-year mortality. Cox proportional hazards regression model showed that only the reinstitution within 14 days was the independent predictor for mortality (P < 0.001). In conclusion, the reinstitution within 14 days was a poor predictor for PMV patients after successful weaning.
authors.affiliation: Division of Pulmonary & Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Mei-Lien
authors.initials: ML
authors.lastname: Tu
authors.forename: Ching-Wan
authors.initials: CW
authors.lastname: Tseng
authors.forename: Yuh Chyn
authors.initials: YC
authors.lastname: Tsai
authors.forename: Chin-Chou
authors.initials: CC
authors.lastname: Wang
authors.forename: Chia-Cheng
authors.initials: CC
authors.lastname: Tseng
authors.forename: Meng-Chih
authors.initials: MC
authors.lastname: Lin
authors.forename: Wen-Feng
authors.initials: WF
authors.lastname: Fang
authors.forename: Yung-Che
authors.initials: YC
authors.lastname: Chen
authors.forename: Shih-Feng
authors.initials: SF
authors.lastname: Liu
mesh_terms: D018806:APACHE; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016638:Critical Illness / Q000401:mortality; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012121:Respiration, Artificial; D013997:Time Factors; D016896:Treatment Outcome; D015300:Ventilator Weaning