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[长期机械通气患者撤机及死亡的预测因素——生存者的生存情况]

[Predictors of weaning and mortality in prolonged mechanical ventilation – surviving survival].

作者信息

Hannun Marcos, Villalba Dario, Díaz Ballve Ladislao, Matesa Amelia, Pedace Paula, Tocalini Pablo, Pérez Calvo Eliana, Scrigna Mariana, Collins Jessica, Areas Laura, Gil Rossetti Gregorio, Planells Fernando

机构信息

Clínica Basilea, Solís 1025, C1078, CABA, Argentina.

Hospital Nacional Alejandro Posadas, Provincia de Buenos Aires, Argentina.

出版信息

Rev Fac Cien Med Univ Nac Cordoba. 2022 Jun 6;79(2):162-167. doi: 10.31053/1853.0605.v79.n2.33184.

Abstract

OBJETIVE

to describe a sample of tracheostomized patients requiring prolonged mechanical ventilation who were admitted to a weaning center, to analyze their evolution and to determine the predictors of weaning failure from mechanical ventilation and of mortality. Design:

DESIGN

an observational and retrospective cohort study was carried out, in the period between January 2005 and December 2017. Setting: weaning and rehabilitation center. Patients: all tracheostomized patients requiring mechanical ventilation who were admitted during the study period were included. Of 1027 patients admitted to the respiratory care service, a consecutive sample of 677 patients was analyzed. Main variables of interest: the main variables were mortality and weaning failure from mechanical ventilation.

RESULTS

: age older than 70 years (OR 1,461 95% CI 1,016-2,099), a cardiovascular history (OR 1,533 95% CI 1,050-2,237), admission due to respiratory disease (OR 1,538 95% CI 1,001-2,364) and presenting more than 105 days of hospitalization (OR 0,408 95% CI 0,261-0,637) were found as predictors of weaning failure. The predictors of mortality were, age over 70 years (OR 2,116 95% CI 1,491-3,004), history of cerebrovascular accident (OR 1,991 95% CI 1,255-3,158), admission to intensive care due to cardiorespiratory arrest (OR 5,821 95% CI 2,193-15,445) and presenting more than 64 days of hospitalization (OR 1, 63 95% CI 1,116-2,292).

CONCLUSIONS

The data found in this study manage to describe factors associated with weaning and mortality of patients in a weaning and rehabilitation center.

摘要

目的

描述入住脱机中心、需要长期机械通气的气管切开患者样本,分析其病情进展,并确定机械通气脱机失败和死亡的预测因素。设计:

设计

于2005年1月至2017年12月期间开展了一项观察性回顾性队列研究。地点:脱机与康复中心。患者:纳入研究期间入住的所有需要机械通气的气管切开患者。在1027名入住呼吸护理服务部的患者中,对连续的677名患者样本进行了分析。主要关注变量:主要变量为死亡率和机械通气脱机失败。

结果

发现年龄大于70岁(比值比1.461,95%置信区间1.016 - 2.099)、有心血管病史(比值比1.533,95%置信区间1.050 - 2.237)、因呼吸系统疾病入院(比值比1.538,95%置信区间1.001 - 2.364)以及住院时间超过105天(比值比0.408,95%置信区间0.261 - 0.637)是脱机失败的预测因素。死亡的预测因素为年龄超过70岁(比值比2.116,95%置信区间1.491 - 3.004)、脑血管意外病史(比值比1.991,95%置信区间1.255 - 3.158)、因心肺骤停入住重症监护病房(比值比5.821,95%置信区间2.193 - 15.445)以及住院时间超过64天(比值比1.63,95%置信区间1.116 - 2.292)。

结论

本研究中发现的数据成功描述了脱机与康复中心患者脱机和死亡相关的因素。

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