Predictores de desvinculación y mortalidad en ventilación mecánica prolongada-Sobrevivir al sobrevivir

OBJECTIVES: to describe a sample of tracheostomized patients requiring prolonged mechanical ventilation who were admitted to a weaning center, to analyze their evolution and to determine the predictors of weaning failure from mechanical ventilation and of mortality. DESIGN: an observational and retrospective cohort study was carried out, in the period between January 2005 and December 2017. SETTING: weaning and rehabilitation center PATIENTS: all tracheostomized patients requiring mechanical ventilation who were admitted during the study period were included. Of 1027 patients admitted to the respiratory care service, a consecutive sample of 677 patients was analyzed. MAIN VARIABLES OF INTEREST: the main variables were mortality and weaning failure from mechanical ventilation. RESULTS: age older than 70 years (OR 1,461 95% CI 1,016-2,099), a cardiovascular history (OR 1,533 95% CI 1,050-2,237), admission due to respiratory disease (OR 1,538 95% CI 1,001-2,364) and presenting more than 105 days of hospitalization (OR 0,408 95% CI 0,261-0,637) were found as predictors of weaning failure. The predictors of mortality were, age over 70 years (OR 2,116 95% CI 1,491-3,004), history of cerebrovascular accident (OR 1,991 95% CI 1,255-3,158), admission to intensive care due to cardiorespiratory arrest (OR 5,821 95% CI 2,193-15,445) and presenting more than 64 days of hospitalization (OR 1, 63 95% CI 1,116-2,292). CONCLUSION: The data found in this study manage to describe factors associated with weaning and mortality of patients in a weaning and rehabilitation center.