title: The Integrative Weaning Index in Elderly ICU Subjects.
abstract: BACKGROUND
  With increasing life expectancy and ICU admission of elderly patients, mechanical ventilation, and weaning trials have increased worldwide.
  
  
  METHODS
  We evaluated a cohort with 479 subjects in the ICU. Patients younger than 18 y, tracheostomized, or with neurologic diseases were excluded, resulting in 331 subjects. Subjects ≥70 y old were considered elderly, whereas those <70 y old were considered non-elderly. Besides the conventional weaning indexes, we evaluated the performance of the integrative weaning index (IWI). The probability of successful weaning was investigated using relative risk and logistic regression. The Hosmer-Lemeshow goodness-of-fit test was used to calibrate and the C statistic was calculated to evaluate the association between predicted probabilities and observed proportions in the logistic regression model.
  
  
  RESULTS
  Prevalence of successful weaning in the sample was 83.7%. There was no difference in mortality between elderly and non-elderly subjects (P= .16), in days of mechanical ventilation (P= .22) and days of weaning (P= .55). In elderly subjects, the IWI was the only respiratory variable associated with mechanical ventilation weaning in this population (P< .001).
  
  
  CONCLUSIONS
  The IWI was the independent variable found in weaning of elderly subjects that may contribute to the critical moment of this population in intensive care.
authors.affiliation: Critical Care Department, Hospital da Polícia Militar de Niterói, Rua Martins Torres 245, Santa Rosa, Niterói, Rio de Janeiro, Brazil. azeredo.lm@gmail.com.
authors.forename: Leandro M
authors.initials: LM
authors.lastname: Azeredo
authors.affiliation: Critical Care Department, Hospital da Polícia Militar de Niterói, Rua Martins Torres 245, Santa Rosa, Niterói, Rio de Janeiro, Brazil.|UNIGRANRIO University Post-Graduate Program associated with the Hospital de Clínicas de Niterói. Rua José de Souza Herdy, 1160 Bairro Vinte e Cinco de Agosto, Duque de Caxias, Rio de Janeiro, Brazil.
authors.forename: Sérgio N
authors.initials: SN
authors.lastname: Nemer
authors.affiliation: Pulmonary and Critical Care Department, Hospital das Clínicas de São Paulo, Avenida Dr. Enéas de Carvalho Aguiar, sétimo andar, sala 7079, São Paulo, Brazil.
authors.forename: Carmen Sv
authors.initials: CS
authors.lastname: Barbas
authors.affiliation: UNIGRANRIO University Post-Graduate Program associated with the Hospital de Clínicas de Niterói. Rua José de Souza Herdy, 1160 Bairro Vinte e Cinco de Agosto, Duque de Caxias, Rio de Janeiro, Brazil.|Critical Care Department, Hospital de Clínicas de Niterói, Rua La Salle 12, Centro, Niterói, Rio de Janeiro, Brazil.
authors.forename: Jefferson B
authors.initials: JB
authors.lastname: Caldeira
authors.affiliation: Biostatistics Department, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Rosângela
authors.initials: R
authors.lastname: Noé
authors.affiliation: Critical Care Department, Hospital de Clínicas de Niterói, Rua La Salle 12, Centro, Niterói, Rio de Janeiro, Brazil.
authors.forename: Bruno L
authors.initials: BL
authors.lastname: Guimarães
authors.affiliation: Post-Graduate Program, Hospital Universitário Pedro Ernesto, Avenida Boulevard 28 de Setembro, 77 Vila Isabel, Rio de Janeiro, Brazil.
authors.forename: Célia P
authors.initials: CP
authors.lastname: Caldas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care / Q000379:methods; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D012306:Risk; D018570:Risk Assessment / Q000379:methods; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D015300:Ventilator Weaning / Q000379:methods / Q000706:statistics & numerical data*
keywords: elderly; mechanical ventilation; weaning