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2017, Number 3

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Rev Cub Med Int Emerg 2017; 16 (3)

Hidden mortality in ventilated patients during 48 hours or more at intensive care unit

Caballero FJA, Caballero LA, Caballero FAD

Language: Spanish
References: 30
Page: 71-90
PDF size: 575.65 Kb.


ABSTRACT

Introduction: hidden mortality (HM) of mechanically ventilated patients has not well been studied in the context of the intensive care units (ICU).
Objective: to establish the HM and the associated risk factors according to the developing in patients who were mechanically ventilated for 48 hours or more in the ICU.
Methods: prospective and analytic trial in an ICU that included all patients who required mechanical ventilation (MV) for 48 hours or more and who was monitored until the discharge from hospital. A descriptive analysis of all variables were performed, after that a logistic regression model including all the variables which showed a univariate analysis p ‹ 0,05.
Results: two-hundred and forty-eight patients (50,1%) where mechanically ventilated during 48 hours or more, 98 (39,5%) of them died at ICU. Nineteen died (13,6%) of the 140 who were studied. Associated factors to an increase of HM were: (values expressed as adjusted odds ratio [CI of 95%]) discharge to intermediate care unit (10,43 [3,22-33,75]) (p=0,000), age › 60 years (5,46 [1,84-16,22]) (p=0,001), APACHE II ≥ 15 points (6,61 [1,83-23,89]) (p=0,001), airway for tracheotomy (TQ) (4,97 [1,79-13,76]) (p=0,001), respiratory as cause of the respiratory failure (3,53 [1,25-9,94) (p=0,013), MV › 7 days (2,85 [1,05-7,70] (p=0,033).
Conclusions: an important number of ventilated patients discharged from ICU died into the hospital, mainly those who presented a COPD exacerbation. The obtained prognosis score identifies a group of patients who can take benefits from specific actions as is required.


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