Zhong Song, Yang Haohao, Zhao Zheren
Department of Intensive Care Unit, Renhe Hospital, Shanghai 200431, P.R. China.
Biomed Rep. 2024 Aug 1;21(4):140. doi: 10.3892/br.2024.1828. eCollection 2024 Oct.
Outcomes in patients receiving invasive mechanical ventilation (IMV) are currently unclear. The present study aimed to explore the prognostic factors of the mortality rate on day 28 in patients treated in the intensive care unit (ICU) and undergoing IMV. The IMV Mortality Prediction Score (IMPRES) of 129 patients in the ICU receiving IMV after emergency (or selective) endotracheal intubation from March 2018 to August 2020 was calculated. The patients were divided into survival (n=73) and death groups (n=56) on day 28. The predictive factors of independent and combined mortality rates were determined using a receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC). The AUC of the IMPRES for predicting patient death on day 28 was 0.785 (95% confidence interval (CI): 0.704-0.864, P<0.01). When the IMPRES cut-off was 4.50, the Youden index was at its maximum (0.487) with a sensitivity of 85.7% and a specificity of 63.0%. The AUC of the ventilator use time (days) at 12.5 days cut-off was 0.653 (95% CI: 0.56-0.746, P<0.01), the Youden index was 0.235 with a sensitivity of 52.1% and a specificity of 71.4%. The AUC of the IMPRES combined with the duration of ventilator use was 0.856 (95% CI: 0.789-0.922, P<0.001), the Youden index was 0.635 with a sensitivity of 84.9% and a specificity of 78.6%. The IMPRES was observed to be the main factor influencing the mortality rate of patients receiving IMV at the ICU on day 28, and the IMPRES combined with the duration of ventilator use had a significant predictive value for the 28-day mortality rates of these patients.
接受有创机械通气（IMV）的患者的预后目前尚不清楚。本研究旨在探讨在重症监护病房（ICU）接受IMV治疗的患者第28天死亡率的预后因素。计算了2018年3月至2020年8月在ICU接受紧急（或选择性）气管插管后接受IMV的129例患者的IMV死亡率预测评分（IMPRES）。在第28天，将患者分为存活组（n = 73）和死亡组（n = 56）。使用受试者工作特征（ROC）曲线和ROC曲线下面积（AUC）确定独立和综合死亡率的预测因素。IMPRES预测患者第28天死亡的AUC为0.785（95%置信区间（CI）：0.704 - 0.864，P < 0.01）。当IMPRES临界值为4.50时，约登指数最大（0.487），灵敏度为85.7%，特异性为63.0%。以12.5天为临界值的呼吸机使用时间（天）的AUC为0.653（95%CI：0.56 - 0.746，P < 0.01），约登指数为0.235，灵敏度为52.1%，特异性为71.4%。IMPRES与呼吸机使用时长相结合的AUC为0.856（95%CI：0.789 - 0.922，P < 0.001），约登指数为0.635，灵敏度为84.9%，特异性为78.6%。观察发现IMPRES是影响ICU中接受IMV治疗的患者第28天死亡率的主要因素，IMPRES与呼吸机使用时长相结合对这些患者的28天死亡率具有显著的预测价值。
