Lai Chih-Cheng, Shieh Jiunn-Min, Chiang Shyh-Ren, Chiang Kuo-Hwa, Weng Shih-Feng, Ho Chung-Han, Tseng Kuei-Ling, Cheng Kuo-Chen
Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Taiwan.
Departments of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Sci Rep. 2016 Jun 14;6:28034. doi: 10.1038/srep28034.
The aims of this study were to investigate the outcomes of patients requiring prolonged mechanical ventilation (PMV) and to identify risk factors associated with its mortality rate. All patients admitted to the respiratory care centre (RCC) who required PMV (the use of MV ≥21 days) between January 2006 and December 2014 were enrolled. A total of 1,821 patients were identified; their mean age was 69.8 ± 14.2 years, and 521 patients (28.6%) were aged >80 years. Upon RCC admission, the APACHE II scores were 16.5 ± 6.3, and 1,311 (72.0%) patients had at least one comorbidity. Pulmonary infection was the most common diagnosis (n = 770, 42.3%). A total of 320 patients died during hospitalization, and the in-hospital mortality rate was 17.6%. A multivariate stepwise logistic regression analysis indicated that patients were more likely to die if they who were >80 years of age, had lower albumin levels (<2 g/dl) and higher APACHE II scores (≥15), required haemodialysis, or had a comorbidity. In conclusion, the in-hospital mortality for patients requiring PMV in our study was 17%, and mortality was associated with disease severity, hypoalbuminaemia, haemodialysis, and an older age.
本研究的目的是调查需要长期机械通气（PMV）的患者的预后情况，并确定与其死亡率相关的风险因素。纳入了2006年1月至2014年12月期间入住呼吸护理中心（RCC）且需要PMV（机械通气使用时间≥21天）的所有患者。共识别出1821例患者；他们的平均年龄为69.8±14.2岁，521例患者（28.6%）年龄>80岁。入住RCC时，急性生理与慢性健康状况评分系统（APACHE II）评分为16.5±6.3，1311例（72.0%）患者至少有一种合并症。肺部感染是最常见的诊断（n = 770，42.3%）。共有320例患者在住院期间死亡，住院死亡率为17.6%。多因素逐步逻辑回归分析表明，年龄>80岁、白蛋白水平较低（<2 g/dl）、APACHE II评分较高（≥15）、需要血液透析或有合并症的患者死亡可能性更大。总之，在我们的研究中，需要PMV的患者的住院死亡率为17%，死亡率与疾病严重程度、低白蛋白血症、血液透析和高龄有关。
