Gender- and age-based differences in outcomes of mechanically ventilated ICU patients: a Chinese multicentre retrospective study

Abstract Background Previous studies have suggested that the gender and/or age of a patient may influence the clinical outcomes of critically ill patients. Our aim was to determine whether there are gender- and age-based differences in clinical outcomes for mechanically ventilated patients in intensive care units (ICUs). Methods We performed a multicentre retrospective study involving adult patients who were admitted to the ICU and received at least 24 h of mechanical ventilation (MV). The patients were divided into two groups based on gender and, subsequently, further grouped based on gender and age < or ≥ 65 years. The primary outcome measure was hospital mortality. Results A total of 853 mechanically ventilated patients were evaluated. Of these patients, 63.2% were men and 61.5% were ≥ 65 years of age. The hospital mortality rate for men was significantly higher than that for women in the overall study population (P = 0.042), and this difference was most pronounced among elderly patients (age ≥ 65 years; P = 0.006). The durations of MV, ICU lengths of stay (LOS), and hospital LOS were significantly longer for men than for women among younger patients (P ≤ 0.013) but not among elderly patients. Multivariate logistic regression analysis revealed that male gender was independently associated with hospital mortality among elderly patients but not among younger patients. Conclusions There were important gender- and age-based differences in the outcomes among mechanically ventilated ICU patients. The combination of male gender and advanced age is strongly associated with hospital mortality.

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Treatment with Neuromuscular Blocking Agents and the Risk of In-hospital Mortality among Mechanically Ventilated Patients with Severe Sepsis

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2014.02.018 ◽

2014 ◽

Vol 46 (4) ◽

pp. 601

Author(s):

Cory Siebe

Keyword(s):

Severe Sepsis ◽

Hospital Mortality ◽

Neuromuscular Blocking ◽

Neuromuscular Blocking Agents ◽

Mechanically Ventilated ◽

Mechanically Ventilated Patients ◽

Blocking Agents ◽

Ventilated Patients

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IN-HOSPITAL MORTALITY IN MECHANICALLY VENTILATED PATIENTS WITH COVID-19 WITH DIFFERENT ARDS PHENOTYPES

CHEST Journal ◽

10.1016/j.chest.2021.07.498 ◽

2021 ◽

Vol 160 (4) ◽

pp. A509

Author(s):

Jooseob Lee ◽

Mariam Charkviani ◽

Harvey Friedman ◽

Guillermo Rodriguez-Nava ◽

Maria Yanez-Bello ◽

...

Keyword(s):

Hospital Mortality ◽

Mechanically Ventilated ◽

Mechanically Ventilated Patients ◽

Ventilated Patients

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Daily Interruption of Sedation with Physical and Occupational Therapy in Mechanically Ventilated Patients

50 Studies Every Intensivist Should Know ◽

10.1093/med/9780190467654.003.0050 ◽

2018 ◽

pp. 309-316

Author(s):

Michael Wolfe ◽

Daniel Saddawi-Konefka

Keyword(s):

Occupational Therapy ◽

Functional Status ◽

Intervention Group ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Control Group ◽

Icu Patients ◽

Mechanically Ventilated ◽

Mechanically Ventilated Patients ◽

Ventilated Patients

Schweickert et al. studied effects of early physical and occupational therapy in mechanically ventilated patients. 109 mechanically ventilated medical ICU patients (with independent functional status prior to hospitalization) were randomized to receive physical and occupational therapy initiated at time of enrollment (intervention group) vs. physical and occupational therapy ordered at the discretion of the primary team (control group), with both groups receiving daily interruptions of sedation. The primary outcome, independent functional status at time of discharge, was met in 59% of the intervention group vs. 35% of the control group (p = 0.02). Lower rates of ICU and hospital delirium were observed in the intervention group. Hospital length of stay and mortality were unaffected. This study demonstrated that physical and occupational therapy can be safely accomplished in critically ill, mechanically ventilated medical ICU patients, and that early implementation of therapy may improve return to independent functional status at hospital discharge.

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Relationship between Volume and Survival in Closed Intensive Care Units Is Weak and Apparent Only in Mechanically Ventilated Patients

Anesthesiology ◽

10.1097/aln.0b013e31829c3029 ◽

2013 ◽

Vol 119 (4) ◽

pp. 871-879 ◽

Cited By ~ 9

Author(s):

Rafael Fernández ◽

Susana Altaba ◽

Lluis Cabre ◽

Victoria Lacueva ◽

Antonio Santos ◽

...

Keyword(s):

Hospital Mortality ◽

Standardized Mortality Ratio ◽

Hospital Level ◽

Mechanically Ventilated ◽

Mechanically Ventilated Patients ◽

Risk Of Death ◽

Mortality Ratio ◽

Low Volume ◽

Predicted Risk ◽

Ventilated Patients

Abstract Background: Recent studies have found an association between increased volume and increased intensive care unit (ICU) survival; however, this association might not hold true in ICUs with permanent intensivist coverage. Our objective was to determine whether ICU volume correlates with survival in the Spanish healthcare system. Methods: Post hoc analysis of a prospective study of all patients admitted to 29 ICUs during 3 months. At ICU discharge, the authors recorded demographic variables, severity score, and specific ICU treatments. Follow-up variables included ICU readmission and hospital mortality. Statistics include logistic multivariate analyses for hospital mortality according to quartiles of volume of patients. Results: The authors studied 4,001 patients with a mean predicted risk of death of 23% (range at hospital level: 14–46%). Observed hospital mortality was 19% (range at hospital level: 11–35%), resulting in a standardized mortality ratio of 0.81 (range: 0.5–1.3). Among the 1,923 patients needing mechanical ventilation, the predicted risk of death was 32% (14–60%) and observed hospital mortality was 30% (12–61%), resulting in a standardized mortality ratio of 0.96 (0.5–1.7). The authors found no correlation between standardized mortality ratio and ICU volume in the entire population or in mechanically ventilated patients. Only mechanically ventilated patients in very low-volume ICUs had slightly worse outcome. Conclusion: In the currently studied healthcare system characterized by 24/7 intensivist coverage, the authors found wide variability in outcome among ICUs even after adjusting for severity of illness but no relationship between ICU volume and outcome. Only mechanically ventilated patients in very low-volume centers had slightly worse outcomes.

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Early Critical Care Transthoracic Echocardiography Improves the Mortality of Patients Undergoing Mechanical Ventilation: Observational Data From Two Large Databases.

10.21203/rs.3.rs-58841/v1 ◽

2020 ◽

Author(s):

Xueshu Yu ◽

Hao Jiang ◽

Wenjing Chen ◽

Lingling Pan ◽

Zhendong Fang ◽

...

Keyword(s):

Mechanical Ventilation ◽

Critical Care ◽

Propensity Score ◽

Hospital Mortality ◽

Transthoracic Echocardiography ◽

Favourable Effect ◽

Research Database ◽

Mechanically Ventilated ◽

Mechanically Ventilated Patients ◽

Ventilated Patients

Abstract Background: Critical care transthoracic echocardiography (TTE) can quickly and accurately assess haemodynamic changes in ICU patients. However, it is not clear whether transthoracic echocardiography improves the prognosis of mechanically ventilated patients. In this study, we hypothesized that early critical care transthoracic echocardiography independently contributes to improvements in mortality in mechanically ventilated patients in the ICU.Methods: This was a retrospective study based on the Medical Information Mart for Intensive Care III (MIMIC-III) database and the eICU Collaborative Research Database (eICU-CRD). Patients undergoing mechanical ventilation for more than 48 hours were selected. The exposure of interest was early TTE. The primary outcome was in-hospital mortality. We used propensity score matching to analyse the association between early TTE and in-hospital mortality and sensitivity analysis, including the inverse probability weighting model and covariate balancing propensity score model, to ensure the robustness of our findings.Results: A total of 8862 patients undergoing mechanical ventilation were enrolled. The adjusted OR showed a favourable effect between the early TTE group and in-hospital mortality [MIMIC: OR 0.77, 95% CI (0.63–0.94), (P=0.01); eICU-CRD: OR 0.78, 95% CI (0.68–0.89), (P<0.01) ]. Furthermore, TTE was also associated with 30-day mortality in the MIMIC database [OR 0.74, 95% CI (0.6-0.92), P=0.01].Conclusions: Early application of critical care transthoracic echocardiography during mechanical ventilation is beneficial for improving in-hospital mortality. Further investigation with prospectively collected data is required to validate this relationship.

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