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Long-term survival of patients treated with prolonged mechanical ventilation small

Fewer than half the patients included in a meta-analysis survived past 1 year after being discharged from the hospital following treatment with prolonged mechanical ventilation, according to study results.

“These data have public health relevance in that prolonged mechanical ventilation is the hallmark of chronic critical illness, an important and growing health challenge,” Emily Damuth, MD, assistant professor of emergency medicine, Cooper Medical School of Rowan University, and colleagues wrote. “An unintended consequence of the advancement of critical care capabilities is the emergence of this distinct population of patients who experience protracted survival without recovery. Chronic critical illness is also extremely resource intensive, costing an estimated $35 billion in health care [expenses] annually [nationwide].”

Emily Damuth

Damuth and colleagues conducted a search of PubMed, CINAHL and the Cochrane Library from 1988 to November 2013 to assess mortality during the first year after prolonged mechanical ventilation, as well as in-hospital mortality and mortality after 1 year.

Of the 6,326 studies identified, the researchers selected 124 from 16 different countries.

Pooled mortality at 1 year for all studies was 59%. Pooled mortality at 1 year was also higher across all practice settings in U.S.-based studies (59%) compared with studies based in United Kingdom (38%) (P < .0001).

Of the 117 studies analyzing mortality at hospital discharge, pooled mortality was 26% prior to discharge.

Damuth and colleagues noted the importance of and need for future research in long-term mechanical ventilation.

“With a comprehensive meta-analysis of long-term survival now completed, the specialty must advance beyond survival as the outcome measure, and focus on multi-dimensional, patient-centered outcome models that include quality of life, cognition, functional dependence, and caregiver burden,” the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.