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Factors Associated with Survival in Patients Undergoing Invasive Mechanical Ventilation in an Intensive Care Unit in Colombia, 2017–2018: A Retrospective Cohort Study

BACKGROUND: Critically ill patients are admitted to intensive care units so they can be comprehensively managed and provided with services not covered in general hospital wards, with the aim to increase their chances of survival. These procedures include invasive mechanical ventilation. OBJECTIVE: T...

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Autores principales: Machado-Alba, Jorge Enrique, Usma-Valencia, Andrés Felipe, Sánchez-Ramírez, Nicolás, Valladales-Restrepo, Luis Fernando, Machado-Duque, Manuel, Gaviria-Mendoza, Andrés
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026090/
https://www.ncbi.nlm.nih.gov/pubmed/33829374
http://dx.doi.org/10.1007/s40801-021-00241-y
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author Machado-Alba, Jorge Enrique
Usma-Valencia, Andrés Felipe
Sánchez-Ramírez, Nicolás
Valladales-Restrepo, Luis Fernando
Machado-Duque, Manuel
Gaviria-Mendoza, Andrés
author_facet Machado-Alba, Jorge Enrique
Usma-Valencia, Andrés Felipe
Sánchez-Ramírez, Nicolás
Valladales-Restrepo, Luis Fernando
Machado-Duque, Manuel
Gaviria-Mendoza, Andrés
author_sort Machado-Alba, Jorge Enrique
collection PubMed
description BACKGROUND: Critically ill patients are admitted to intensive care units so they can be comprehensively managed and provided with services not covered in general hospital wards, with the aim to increase their chances of survival. These procedures include invasive mechanical ventilation. OBJECTIVE: The aim of this study was to identify the factors associated with survival in critically ill patients who required invasive mechanical ventilation in an intensive care unit of a tertiary-level hospital in Colombia. METHODS: This was a retrospective follow-up study of a cohort of adult patients who required invasive mechanical ventilation in an intensive care unit in San José de Buga Hospital, between 2017 and 2018. Sociodemographic, clinical, and pharmacological variables were identified. Using Cox regression, variables associated with survival and complications were identified. RESULTS: A total of 357 patients were analyzed. The average age was 64.8 ± 18.9 years, and 52.9% were male. The most frequent diagnoses were sepsis/septic shock (38.4%) and trauma (17.4%). The main factors associated with shorter survival were advanced age (HR 0.97; 95% CI 0.96–0.99), a diagnosis of septic shock (HR 0.29; 95% CI 0.18–0.48) or diabetes mellitus at admission (HR 0.57; 95% CI 0.33–0.98), a healthcare-associated infection (HR 0.51; 95% CI 0.33–0.80), and the need for vasopressors (HR 0.36; 95% CI 0.22–0.59). The administration of systemic corticosteroids was associated with a higher probability of survival (HR 1.93; 95% CI 1.15–3.25). CONCLUSIONS: The use of systemic corticosteroids was associated with a greater probability of survival in critically ill patients who required invasive mechanical ventilation in an intensive care unit. The identification of the variables associated with a higher risk of dying should allow care protocols to be improved, thereby extending the life expectancy of these patients.
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spelling pubmed-80260902021-04-08 Factors Associated with Survival in Patients Undergoing Invasive Mechanical Ventilation in an Intensive Care Unit in Colombia, 2017–2018: A Retrospective Cohort Study Machado-Alba, Jorge Enrique Usma-Valencia, Andrés Felipe Sánchez-Ramírez, Nicolás Valladales-Restrepo, Luis Fernando Machado-Duque, Manuel Gaviria-Mendoza, Andrés Drugs Real World Outcomes Original Research Article BACKGROUND: Critically ill patients are admitted to intensive care units so they can be comprehensively managed and provided with services not covered in general hospital wards, with the aim to increase their chances of survival. These procedures include invasive mechanical ventilation. OBJECTIVE: The aim of this study was to identify the factors associated with survival in critically ill patients who required invasive mechanical ventilation in an intensive care unit of a tertiary-level hospital in Colombia. METHODS: This was a retrospective follow-up study of a cohort of adult patients who required invasive mechanical ventilation in an intensive care unit in San José de Buga Hospital, between 2017 and 2018. Sociodemographic, clinical, and pharmacological variables were identified. Using Cox regression, variables associated with survival and complications were identified. RESULTS: A total of 357 patients were analyzed. The average age was 64.8 ± 18.9 years, and 52.9% were male. The most frequent diagnoses were sepsis/septic shock (38.4%) and trauma (17.4%). The main factors associated with shorter survival were advanced age (HR 0.97; 95% CI 0.96–0.99), a diagnosis of septic shock (HR 0.29; 95% CI 0.18–0.48) or diabetes mellitus at admission (HR 0.57; 95% CI 0.33–0.98), a healthcare-associated infection (HR 0.51; 95% CI 0.33–0.80), and the need for vasopressors (HR 0.36; 95% CI 0.22–0.59). The administration of systemic corticosteroids was associated with a higher probability of survival (HR 1.93; 95% CI 1.15–3.25). CONCLUSIONS: The use of systemic corticosteroids was associated with a greater probability of survival in critically ill patients who required invasive mechanical ventilation in an intensive care unit. The identification of the variables associated with a higher risk of dying should allow care protocols to be improved, thereby extending the life expectancy of these patients. Springer International Publishing 2021-04-07 /pmc/articles/PMC8026090/ /pubmed/33829374 http://dx.doi.org/10.1007/s40801-021-00241-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research Article
Machado-Alba, Jorge Enrique
Usma-Valencia, Andrés Felipe
Sánchez-Ramírez, Nicolás
Valladales-Restrepo, Luis Fernando
Machado-Duque, Manuel
Gaviria-Mendoza, Andrés
Factors Associated with Survival in Patients Undergoing Invasive Mechanical Ventilation in an Intensive Care Unit in Colombia, 2017–2018: A Retrospective Cohort Study
title Factors Associated with Survival in Patients Undergoing Invasive Mechanical Ventilation in an Intensive Care Unit in Colombia, 2017–2018: A Retrospective Cohort Study
title_full Factors Associated with Survival in Patients Undergoing Invasive Mechanical Ventilation in an Intensive Care Unit in Colombia, 2017–2018: A Retrospective Cohort Study
title_fullStr Factors Associated with Survival in Patients Undergoing Invasive Mechanical Ventilation in an Intensive Care Unit in Colombia, 2017–2018: A Retrospective Cohort Study
title_full_unstemmed Factors Associated with Survival in Patients Undergoing Invasive Mechanical Ventilation in an Intensive Care Unit in Colombia, 2017–2018: A Retrospective Cohort Study
title_short Factors Associated with Survival in Patients Undergoing Invasive Mechanical Ventilation in an Intensive Care Unit in Colombia, 2017–2018: A Retrospective Cohort Study
title_sort factors associated with survival in patients undergoing invasive mechanical ventilation in an intensive care unit in colombia, 2017–2018: a retrospective cohort study
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026090/
https://www.ncbi.nlm.nih.gov/pubmed/33829374
http://dx.doi.org/10.1007/s40801-021-00241-y
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