Predicting Mechanical Ventilation for More Than 7 Days in the Emergency Department
Abstract Background The duration of mechanical ventilation (MV) required by patients admitted to the emergency department (ED) is difficult to predict. We investigated the duration of MV in ED-admitted patients, as well as their clinical progress.Methods We investigated the duration of MV in adult patients (aged ≥18 years) who were attached to ventilators in our ED between January and December 2017. The patients were divided into two groups; MV <7 days and MV ≥7 days. The patients’ demographic characteristics, diagnoses, clinical features, and underlying diseases were compared between two groups.Results The study comprised 282 patients including 142 in the MV <7 days group and 140 in the MV ≥7 days group. The MV ≥7 days group had more patients diagnosed with metabolic disorder, pneumonia, neurological disease, sepsis, and multiple trauma, and also had a greater proportion of patients with dementia or stroke as the underlying disease. The mean C-reactive protein level in the MV ≥7 days group was 6.4 mg/dL, which was higher than that in the MV <7 days group. The risk factors for requiring ≥7 days of MV were identified as a diagnosis of stroke as well as having the underlying diseases of cancer and stroke or dementia. Among the laboratory test results, pH, HCO3- , and albumin <3.5 g/dL were identified as factors influencing the duration of MV.Conclusion MV for ≥7 days is predicted to be required for patients admitted for a stroke; those with underlying cancer or stroke; and those with adverse pH, HCO3-, and albumin blood test results.