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Han, Moon, Lee, Cho, and Na: Clinical Characteristics and Prognosis of Elderly Patients Receiving Prolonged Mechanical Ventilation in the Medical Intensive Care Unit at a University Hospital
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 64(6): 445-450.

Published online: 30 June 2008

DOI: https://doi.org/10.4046/trd.2008.64.6.445

Clinical Characteristics and Prognosis of Elderly Patients Receiving Prolonged Mechanical Ventilation in the Medical Intensive Care Unit at a University Hospital

Min Soo Han, M.D., Kyoung Min Moon, M.D., Yang Deok Lee, M.D., Yongseon Cho, M.D., Dong Jib Na, M.D.

Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.

Address for correspondence: Min Soo Han, M.D. Department of Internal Medicine, Eulji University Hospital, 1306, Dunsan-dong, Seo-gu, Daejeon 302-799, Korea. Phone: 82-42-611-3151, Fax: 82-42-611-3853, hms43@eulji.ac.kr

Received 11 March 2008       Accepted 11 June 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Background

As the number of older-aged people increases, the number of elderly patients who receive critical care services is expected to increase substantially. The objective of this study was to examine the clinical characteristics and outcomes of elderly patients who receive mechanical ventilation for more than 30 days in the medical intensive care unit (MICU) at a university hospital.

Methods

We retrospectively examined forty-one elderly patients (≥65 years old) who were receiving mechanical ventilation, from April 2004 to March 2007, for periods exceeding 30 days at the MICU at Eulji University Hospital.

Results

The MICU and hospitalmortality rate were 60.9% and 65.9%, respectively. The mean length of the ICU stay was 57.5 days and the mean duration of mechanical ventilation was 49.3 days. The most common reason for MICU admission was acute respiratory failure (73.2%), followed by sepsis (12.2%), neurological problems (9.8%), and gastrointestinal bleeding (4.9%). The Acute Physiology and Chronic Health Evaluation (APACHE) II scores were higher for the nonsurvivors than for the survivors (28.0 vs. 25.0, respectively, p=0.03). The nonsurvivors received more red blood cell (RBC) transfusions during their ICU stay than did the survivors (84.0% vs. 43.8%, respectively p=0.007). The factors associated with hospital death were the APACHE II score and if the patient had received a RBC transfusion.

Conclusion

The APACHE II score and a RBC transfusion were predictors of increased hospital mortality for the elderly patients who were on prolonged mechanical ventilation. These predictors may assist physicians to make clinical decisions for this patient population.

Keywords: Mechanical ventilation, Elderly, Intensive care unit

Figures and Tables

Table 1
Baseline characteristics of the patients
trd-64-445-i001

SD: standard deviation; DM: diabetes mellitus; APACHE: acute physiology and chronic health evaluation; ICU: intensive care unit.

*Chronic obstructive pulmonary disease, tuberculous destroyed lung, idiopathic pulmonary fibrosis.

Values are expressed as number (percentage) unless otherwise indicated.

Table 2
Intensive care unit course
trd-64-445-i002

ICU: intensive care unit; SD: standard deviation; ESRD: end-stage renal disease; MV: mechanical ventilation.

Values are expressed as number (percentage) unless otherwise indicated.

Table 3
Comparison between survivors and nonsurvivors
trd-64-445-i003

APACHE: acute physiology and chronic health evaluation; SD: standard deviation; MV: mechanical ventilation; ICU: intensive care unit.

Values are expressed as mean±SD unless otherwise indicated.

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