title: Prognostic factors of patients requiring prolonged mechanical ventilation in a medical intensive care unit of Korea.
abstract: BACKGROUND
  We evaluated the clinical outcomes and prognostic factors of patients requiring prolonged mechanical ventilation (PMV), defined as ventilator care for ≥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±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±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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Mi Hyun
authors.initials: MH
authors.lastname: Kim
authors.forename: Woo Hyun
authors.initials: WH
authors.lastname: Cho
authors.forename: Kwangha
authors.initials: K
authors.lastname: Lee
authors.forename: Ki Uk
authors.initials: KU
authors.lastname: Kim
authors.forename: Doo Soo
authors.initials: DS
authors.lastname: Jeon
authors.forename: Hye-Kyung
authors.initials: HK
authors.lastname: Park
authors.forename: Yun Seong
authors.initials: YS
authors.lastname: Kim
authors.forename: Min Ki
authors.initials: MK
authors.lastname: Lee
authors.forename: Soon Kew
authors.initials: SK
authors.lastname: Park