RESUMO
BACKGROUND: Over recent years the number of mechanically ventilated patients in internal medicine departments has grown. These patients are elderly, mostly disabled and suffer from many chronic illnesses. Most of them require prolonged mechanical ventilation. OBJECTIVES: The study aimed to evaluate the population of mechanically ventilated patients in an internal department, the treatment and outcomes, particularly the morbidity in hospitalization and to identify the prognostic causes of death. METHODS: A retrospective study was conducted to check the medical records of ventilated patients between the years 2012- 2013 in internal medicine departments including demographic information, chronic illnesses, cause of hospitalization and ventilation, complications and results of treatment. RESULTS: The study includes 97 patients over the age of 60, 50% of them disabled, average Apache score was 29.9; 65% of the patients required ventilation for over 3 days and 35% for over 10 days; 71% of the patients died. The most common causes of death were pneumonia, sepsis, cerebrovascular accident, cardiac event, worsening of heart failure, worsening of chronic obstructive pulmonary disease or a combination of these. The patients who died displayed an Apache score significantly higher at admittance to the hospital. Significant risk factors for mortality included chronic diabetes, sepsis, pneumonia and renal failure. CONCLUSIONS: The results raise the question of whether to increase the number of beds for internal intensive care. A discussion is required among medical personnel and laymen to define a group of patients who should not deteriorate to mechanical ventilation or any other invasive procedures.
