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Chon, Choi, Lim, Koh, Oh, Shim, Lee, Kim, Kim, Kim, and Hong: The 3 years Prognosis of Patients with Long Term Mechanical Ventilation in Medical Intensive Care Unit at a University Hospital
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 62(5): 398-405.

Published online: 31 May 2007

DOI: https://doi.org/10.4046/trd.2007.62.5.398

The 3 years Prognosis of Patients with Long Term Mechanical Ventilation in Medical Intensive Care Unit at a University Hospital

Gyu Rak Chon, M.D., Ik Su Choi, M.D., Chae-Man Lim, M.D., Younsuck Koh, M.D., Yeon-Mok Oh, M.D., Tae Sun Shim, M.D., Sang Do Lee, M.D., Woo Sung Kim, M.D., Dong-Soon Kim, M.D., Won Dong Kim, M.D., Sang-Bum Hong, M.D.

Division of Pulmonary and Critical Care Medicine, Asan Medical Center, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.

Address for correspondence: Sang-Bum Hong, M.D. Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, 388-1, Pungnap-2dong, Seoul, 138-736, Korea. Phone: 82-2-3010-3893, FAX: 82-2-3010-6968, sbhong@amc.seoul.kr

Received 9 March 2007       Accepted 4 May 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Background

There is little data on the 3 year prognosis and quality of life of patients on long-term (>72 hour) mechanical ventilation in a medical intensive care unit (MICU).

Methods

Patients with long-term mechanical ventilation from May 2003 through July 2003 in MICU of Asan Medical Center, Seoul were enrolled in this studay. The survival rates were observed prospectively at 1, 3, 6, 12, 24, 36 months, and the quality of life of survivor was measured at 12 months by using Short Form 36 (SF-36).

Results

The survival rate at 1, 3, 6, 12, 24 and 36 months was 54.8% (40/73), 39.7% (29/73), 30.1% (22/73), 20.5% (15/73), 18.3% (13/71) and 16.9% (12/71), respectively. There was a similar survival rate regardless of the diseases that required mechanical ventilation. A neoplasm or chronic liver disease had a worse survival rate than chronic lung or kidney disease (p<0.05). Each SF-36 domain except for the Role-emotional was inferior to the general population.

Conclusions

The survival rate of patients with mechanical ventilation more than 72 hours is decreases continuously until 12 months but is relatively constant from 12 to 36 months. In these patients quality of life is also decrased.

Keywords: Long term mechanical ventilation, Intensive care unit, Survival rate, Quality of life

Figures and Tables

Figure 1
Survival rates according to major disease that needed mechanical ventilation during observation period. There was no difference in survival rate among diseases that needs mechanical ventilation at 1, 3, 6, 12, 24, 36 month(p>0.05).
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Figure 2
Survival rates according to underlying disease during observation period. Neoplasm or chronic liver disease were worse than chronic lung or kidney disease in survival rate at 3, 6, 12, 24, 36 month(p<0.05).
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Table 1
Demographics and clinical characteristics of patients with long term mechanical ventilation(n=73)
trd-62-398-i001

*Intensive care unit, †Acute physiologic and chronic health evaluation, ‡Mechanical ventilation.

Table 2
Indications of long term mechanical ventilation(n=73)
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Table 3
Underlying diseases of long term mechanical ventilator patients(n=68)
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Table 4
The ventilator modes and settings at the time of 72 hours according to the reason for initiating mechanical ventilation
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*Acute exacerbation of chronic respiratory failure, †Pressure controlled ventilation, ‡Pressure support, §Noninvasive positive pressure ventilation, ∥Tidal volume, Positive end expiratory pressure, **Respiration rate, ††Peak inspiratory pressure.

Table 5
Predictors affecting 1 year survival rate in univariate analysis
trd-62-398-i005

*Intensive care unit, †Acute physiologic and chronic health evaluation, ‡Peak inspiratory pressure, §Mechanical ventilation.

Table 6
Comparison of quality of life (SF-36) between study group and control group
trd-62-398-i006

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