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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.
Machado-Alba, Jorge Enrique; Usma-Valencia, Andrés Felipe; Sánchez-Ramírez, Nicolás; Valladales-Restrepo, Luis Fernando; Machado-Duque, Manuel; Gaviria-Mendoza, Andrés.
  • Machado-Alba JE; Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Calle 105 No. 14-140, 660003, Pereira, Risaralda, Colombia. machado@utp.edu.co.
  • Usma-Valencia AF; Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Calle 105 No. 14-140, 660003, Pereira, Risaralda, Colombia.
  • Sánchez-Ramírez N; Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Calle 105 No. 14-140, 660003, Pereira, Risaralda, Colombia.
  • Valladales-Restrepo LF; Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Calle 105 No. 14-140, 660003, Pereira, Risaralda, Colombia.
  • Machado-Duque M; Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia.
  • Gaviria-Mendoza A; Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Calle 105 No. 14-140, 660003, Pereira, Risaralda, Colombia.
Drugs Real World Outcomes ; 8(3): 417-425, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1540320
Semantic information from SemMedBD (by NLM)
1. Invasive mechanical ventilation NOS TREATS Patients
Subject
Invasive mechanical ventilation NOS
Predicate
TREATS
Object
Patients
2. Critical Illness PROCESS_OF Patients
Subject
Critical Illness
Predicate
PROCESS_OF
Object
Patients
3. Ward NEG_LOCATION_OF C0557854
Subject
Ward
Predicate
NEG_LOCATION_OF
Object
C0557854
4. Patients LOCATION_OF CD69 protei
Subject
Patients
Predicate
LOCATION_OF
Object
CD69 protei
5. Hospitals LOCATION_OF Retrospective Studies
Subject
Hospitals
Predicate
LOCATION_OF
Object
Retrospective Studies
6. intensive care unit LOCATION_OF Retrospective Studies
Subject
intensive care unit
Predicate
LOCATION_OF
Object
Retrospective Studies
7. Adrenal Cortex Hormones TREATS Critical Illness
Subject
Adrenal Cortex Hormones
Predicate
TREATS
Object
Critical Illness
8. Adrenal Cortex Hormones TREATS Patients
Subject
Adrenal Cortex Hormones
Predicate
TREATS
Object
Patients
9. Invasive mechanical ventilation NOS TREATS Patients
Subject
Invasive mechanical ventilation NOS
Predicate
TREATS
Object
Patients
10. Critical Illness PROCESS_OF Patients
Subject
Critical Illness
Predicate
PROCESS_OF
Object
Patients
11. Wards, General NEG_LOCATION_OF Services
Subject
Wards, General
Predicate
NEG_LOCATION_OF
Object
Services
12. Patients LOCATION_OF CD69 protein, human|CD69
Subject
Patients
Predicate
LOCATION_OF
Object
CD69 protein, human|CD69
13. Hospitals LOCATION_OF Retrospective Studies
Subject
Hospitals
Predicate
LOCATION_OF
Object
Retrospective Studies
14. intensive care unit LOCATION_OF Retrospective Studies
Subject
intensive care unit
Predicate
LOCATION_OF
Object
Retrospective Studies
15. Adrenal Cortex Hormones TREATS Critical Illness
Subject
Adrenal Cortex Hormones
Predicate
TREATS
Object
Critical Illness
16. Adrenal Cortex Hormones TREATS Patients
Subject
Adrenal Cortex Hormones
Predicate
TREATS
Object
Patients
ABSTRACT

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.

Full text: Available Collection: International databases Database: MEDLINE Type of study: Etiology study / Clinical Practice Guide / Observational study / Prognostic study / Risk factors Country/Region as subject: South America / Colombia Language: English Journal: Drugs Real World Outcomes Year: 2021 Document Type: Article Affiliation country: S40801-021-00241-y

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Etiology study / Clinical Practice Guide / Observational study / Prognostic study / Risk factors Country/Region as subject: South America / Colombia Language: English Journal: Drugs Real World Outcomes Year: 2021 Document Type: Article Affiliation country: S40801-021-00241-y