Investigation of clinical characteristics of patients undergoing invasive mechanical ventilation in the intensive care unit

The primary aim of this study is to examine clinical characteristics of patients undergoing invasive mechanical ventilation in the intensive care unit. Secondary aim is to determine independent risk factors for prolonged mechanical ventilation. Patients admitted to Hacettepe University Internal Medicine Intensive Care Unit between 2008 and 2022 were included. Total of 3899 patients on the day of admission to intensive care were recorded. It was observed that 1698 (43.5%) of patients received invasive mechanical ventilation. In the invasive mechanical ventilation group, the mean age was higher (61.7±18.1 vs. 58.7±19.4), male gender was dominant (51.1% vs. 45.2%), and recorded comorbidities were more common. It was determined that the duration of intensive care and hospital stays and mortality rates were higher. Two different cut-off values for prolonged mechanical ventilation were determined as 14 and 21 days, and separate statistical analyzes were performed for each. There were 501 patients (29.5%) in whom invasive mechanical ventilation was applied for ≥14 days, and 318 patients (18.7%) received invasive mechanical ventilation for ≥21 days. Patients requiring prolonged mechanical ventilation had longer lenght of stay and higher mortality rates. Independent risk factors for mechanical ventilation of ≥14 days were determined as age ≥65 years (OR=1,38; CI 95% [1,03-1,85]; p=0,031), neurological disorders (OR=2,03; CI 95% [1,39-2,95]; p <0,001), APACHE II >21 (OR=2,03; CI 95% [1,50-2,74]; p <0,001), admission SOFA >7 (OR=1,51; CI 95% [1,10-2,08]; p=0,011), ARDS (OR=5,49; CI 95% [3,59-8,41]; p <0,001), intubation in medical ICU (OR=2,00; CI 95% [1,49-2,70]; p <0,001) and CRP >10 mg/dL (OR=1,45; CI 95% [1,08-1,94]; p=0,012). As a result, it has been shown that although invasive mechanical ventilation is a life-saving treatment method, it causes prolonged hospital stays and an increase in mortality. It was determined that increase in weaning attempts and durations were associated with longer hospital stays and higher mortality. Independent risk factors associated with prolonged mechanical ventilation were identified as age ≥65 years, neurological disorders, APACHE II >21, admission SOFA >7, ARDS, intubation in medical ICU and CRP >10 mg/dL.