Study objectives: To describe the 2-month mortality and
functional status of adult patients receiving prolonged (at least
48 h) mechanical ventilation (MV), and to identify patient
characteristics that are associated with 2-month mortality.
Design: Prospective cohort study.
Four ICUs at a tertiary-care institution.
Eight hundred seventeen patients who received prolonged MV.
results: Median age, sex distribution, and median Charlson
comorbidity score of the 817 patients were 65 years, 45.8% women, and
1, respectively. The median scores on Katz Activities of Daily Living,
Instrumental Activities of Daily Living Deficits, and Medical Outcomes
Study Short-Form 36 surveys before hospitalization were 0, 1, and 50,
respectively. Median APACHE (acute physiology and chronic health
evaluation) III score and probability of hospital death for the cohort
were 64 and 0.31, respectively. Median duration of MV was 9 days.
Two-month mortality was 43%. Independent predictors of mortality at 2
months were age, comorbidities, and prehospital functional status. The
adjusted odds of dying within 2 months increased 34% for each decade
increase in age. Functional status deteriorated at 2 months compared to
functional status prior to hospitalization, and 35% of the survivors
were at risk for clinical depression. Among the 2-month survivors for
whom the need for a caregiver was assessed, 78% had a caregiver.
Conclusions: Older age, in addition to functional status
and comorbidities, was associated with increased mortality at 2 months.
Functional status of survivors declined at 2 months.