Clinical outcomes and prognostic factors for prolonged mechanical ventilation in patients with acute stroke and brain trauma

Journal of the Formosan Medical Association

Shu-Chen Chang¹  Tzu-Hsuan Chiu¹  Li-Yi Chan¹  Kuo-Chin Kao²  Chung-Shu Lee³  Li-Fu Li⁴  Chee-Jen Chang⁵  Hsiang Hsuan Chen⁵  Hung-Yu Huang⁶  Shu-Min Lin⁷  Ning-Hung Chen⁸  Han-Chung Hu⁸ 

[1] Chang Gung University, Taoyuan, Taiwan;Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan;Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan;Research Services Center for Health Information, Chang Gung University, Taoyuan, Taiwan;Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan;Division of Pulmonary and Critical Care, Department of Internal Medicine, Saint Paul's Hospital, Taoyuan, Taiwan;Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan;School of Medicine, College of Medicine, Chang Gung University, Kaohsiung, Taiwan;

关键词: Brain trauma;    Intracerebral hemorrhage;    Prolonged mechanical ventilation;    Stroke;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background/Purpose: Neurological dysfunction is a common condition necessitating prolonged mechanical ventilation (PMV). We investigated the clinical features and outcomes of patients with acute neurological diseases requiring PMV. Methods: This retrospective observational study was conducted at the Respiratory Care Center (RCC) of Chang Gung Memorial Hospital, Taiwan, between January 2011 and January 2014. The main outcome was weaning success, defined as successful withdrawal from mechanical ventilator support for more than 5 days. Results: The study included 103 patients with acute stroke and brain trauma receiving PMV. Weaning success was reported in 63 (61%) patients and weaning failure was reported in 40 (39%) patients. Patients in the weaning failure group were older and had a lower RCC Glasgow Coma Scale (GCS) score (6.0 vs 7.9, p = 0.005), lower albumin level (2.8 vs 3.1, p = 0.015), longer RCC stay (28.7 vs 21.3 days, p = 0.017), and higher in-hospital mortality rate (47% vs 9%, p < 0.01). Multivariate analysis revealed that reduced RCC GCS score is an independent prognostic factor for weaning failure (odds ratio [OR] = 1.22, 95% confidence interval [CI] = 1.05–1.46, p = 0.016) and that per unit increase of RCC GCS score is associated with a lower risk of in-hospital mortality (OR = 0.83, 95% CI = 0.70–0.96, p = 0.019). Conclusion: Reduced RCC GCS score is an independent prognostic factor for weaning failure, and is associated with increased in-hospital mortality rates in patients with acute stroke and brain trauma requiring PMV.

【 授权许可】

Unknown