Mortality in patients receiving prolonged invasive mechanical ventilation time in the emergency department: A retrospective cohort study

BACKGROUND: Patients waiting for intensive care unit (ICU) admission cause emergency department (ED) crowding and have an increased risk of mortality and length of stay (LOS) in hospital, which increase the hospitalization cost. This study aimed to investigate the correlation between mortality and invasive mechanical ventilation (IMV) time in patients in the ED. METHODS: A retrospective cohort study was conducted in patients who received IMV in the ED of Ramathibodi Hospital. The correlation between mortality at 28 days after intubation and IMV time in the ED was analyzed. The cutoff time was analyzed to determine prolonged and nonprolonged IMV times. ICU ventilation time, length of ICU stay, and LOS in the hospital were also analyzed to determine their correlations between IMV time in the ED. RESULTS: In this study, 302 patients were enrolled, 71 died, and 231 survived 28 days after receiving IMV in the ED. We found that the duration of >12 h of IMV in the ED increased the 28-day mortality rate by 1.98 times (P = 0.036). No correlations were found between IMV time in the ED and ventilation time in the ICU, length of ICU stay, and LOS in the hospital. CONCLUSION: More than 12 h of IMV time in the ED correlated with mortality at 28 days after initiation of IMV. No associations were found between prolonged IMV time in the ED with ventilation time in the ICU, length of ICU stay, and LOS in the hospital.