Modification of the prolonged mechanical ventilation prognostic model score to predict short-term and 1-year mortalities.
Respirology
; 24(2): 179-185, 2019 02.
Article
em En
| MEDLINE
| ID: mdl-30223306
ABSTRACT
BACKGROUND AND OBJECTIVE:
We aimed to validate the use of the Prolonged Mechanical Ventilation Prognostic Model (ProVent) score in medically ill patients with co-morbidities and to modify the score to improve the prediction power of 1-year mortality.METHODS:
We conducted a retrospective study of all patients who required at least 14 days of mechanical ventilation (MV) and established two groups (14-20 and ≥21 days of MV) based on the MV duration. We performed external validation of the present ProVent Model in our patients on Day 14 (or Day 21 for the ≥21-day MV group) of MV, and established the extended ProVent model, while considering the albumin and bilirubin levels and co-morbidities (chronic obstructive pulmonary disease and cancer).RESULTS:
A total of 1288 patients (666 and 622 with 14-20 and ≥21 days of MV, respectively) with at least 14 days of MV were enrolled. The 1-year mortality was 79.9% and 78.7% in the ≥21- and 14-20-day groups, respectively. Most of the observed mortality rates in all groups were within the 95% CI of predicted mortality as per the ProVent Model, except for the ProVent scores of 0 and 5. In the ProVent model, the area under the curve for the prediction of 1-year mortality was 0.69 in all patients with ≥14 days of MV, whereas in the extended ProVent model, the area under the curve was 0.89.CONCLUSION:
The extended ProVent model, which considers co-morbidities and laboratory data, increases the prediction power of 1-year mortality in patients who require prolonged MV.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Respiração Artificial
/
Mortalidade
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Doença Pulmonar Obstrutiva Crônica
/
Neoplasias
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Respirology
Ano de publicação:
2019
Tipo de documento:
Article