title: Outcomes and prognostic factors in patients with prolonged acute mechanical ventilation: A single-center study in Korea.
abstract: OBJECTIVE
  The purpose of the study is to evaluate outcomes and objective parameters related to poor prognosis in patients who were defined as prolonged acute mechanical ventilation (PAMV; ventilator care ≥96 hours) in the medical intensive care unit of a university-affiliated tertiary care hospital in Korea.
  
  
  METHODS
  We analyzed retrospectively clinical data gathered from the medical records on day 4 of MV between 2008 and 2013. In total, 311 were categorized as PAMV.
  
  
  RESULTS
  Their median age was 67 years (range, 18-93 years), and 71.7% were male. The 28-day mortality rate after intensive care unit admission was 34.7%. Four variables on day 4 of mechanical ventilation (need for neuromuscular blockers [hazard ratio {HR}, 2.432; 95% confidence interval, 1.337-4.422], need for vasopressors [HR, 2.312; 95% confidence interval, 1.258-4.248], need for hemodialyses [HR, 1.913; 95% confidence interval, 1.018-3.595], and body mass index ≤21 kg/m(2) [HR, 1.827; 95% confidence interval, 1.015-3.288]) were independent factors associated with mortality based on a Cox proportional hazards model. As the number of these prognostic factors increased, the survival rate decreased.
  
  
  CONCLUSIONS
  Four clinical factors (body mass index ≤21, requirement for neuromuscular blockers, vasopressors, and hemodialysis) on day 4 of mechanical ventilation were associated with 28-day mortality in PAMV patients.
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.
authors.forename: Sang Hee
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.
authors.forename: Min Ji
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.
authors.forename: Eun Suk
authors.initials: ES
authors.lastname: Jeong
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.
authors.forename: Eun-Jung
authors.initials: EJ
authors.lastname: Jo
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.
authors.forename: Jung Seop
authors.initials: JS
authors.lastname: Eom
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.
authors.forename: Jeong Ha
authors.initials: JH
authors.lastname: Mok
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.
authors.forename: Mi Hyun
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.
authors.forename: Ki Uk
authors.initials: KU
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.
authors.forename: Hye-Kyung
authors.initials: HK
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.
authors.forename: Min Ki
authors.initials: MK
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea. Electronic address: jubilate@pusan.ac.kr.
authors.forename: Kwangha
authors.initials: K
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009466:Neuromuscular Blocking Agents / Q000627:therapeutic use*; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D056910:Republic of Korea / Q000453:epidemiology; D012121:Respiration, Artificial / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
chemical_list: D009466:Neuromuscular Blocking Agents; D014662:Vasoconstrictor Agents
keywords: Intensive care unit; Prognosis; Prolonged acute mechanical ventilation