The Integrative Weaning Index in Elderly ICU Subjects.

BACKGROUND: With increasing life expectancy and ICU admission of elderly patients, mechanical ventilation, and weaning trials have increased worldwide. METHODS: We evaluated a cohort with 479 subjects in the ICU. Patients younger than 18 y, tracheostomized, or with neurologic diseases were excluded,...

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Published in:Respiratory Care Vol. 62; no. 3; pp. 333 - 340
Main Authors: Azeredo, Leandro M., Nemer, Sérgio N., Barbas, Carmen S. V., Caldeira, Jefferson B., Noé, Rosângela, Guimarães, Bruno L., Caldas, Célia P.
Format: research tables/charts Journal Article
Published: Mary Ann Liebert, Inc. Mar2017
Online Access:View this record in EBSCOhost
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      dt: Mar2017
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      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
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        atl: The Integrative Weaning Index in Elderly ICU Subjects.
      aug:
        au:
          Azeredo, Leandro M.
          Nemer, Sérgio N.
          Barbas, Carmen S. V.
          Caldeira, Jefferson B.
          Noé, Rosângela
          Guimarães, Bruno L.
          Caldas, Célia P.
        affil: Critical Care Department, Hospital da Polícia Militar de Niterói, Rua Martins Torres 245, Santa Rosa, Niterói, Rio de Janeiro, Brazil
      sug:
        subj:
          Ventilator Weaning In Old Age
          Critically Ill Patients
          Intensive Care Units
          Instrument Validation
          Aged
          Critical Care
          Hospital Mortality
          Hospitalization
          Human
          Logistic Regression
          Prevalence
          Respiration, Artificial
          Retrospective Design
          Tracheostomy
          Prospective Studies
          Treatment Outcomes
          P-Value
          Chi Square Test
          T-Tests
          Data Analysis Software
          APACHE (Acute Physiology and Chronic Health Evaluation)
          Clinical Assessment Tools
          Sensitivity and Specificity
          Middle Age
          Adult
          Confidence Intervals
          Aged: 65+ years
          Middle Aged: 45-64 years
          Adult: 19-44 years
      ab: BACKGROUND: With increasing life expectancy and ICU admission of elderly patients, mechanical ventilation, and weaning trials have increased worldwide. METHODS: We evaluated a cohort with 479 subjects in the ICU. Patients younger than 18 y, tracheostomized, or with neurologic diseases were excluded, resulting in 331 subjects. Subjects ≥70 y old were considered elderly, whereas those <70 y old were considered non-elderly. Besides the conventional weaning indexes, we evaluated the performance of the integrative weaning index (IWI). The probability of successful weaning was investigated using relative risk and logistic regression. The Hosmer-Lemeshow goodness-of-fit test was used to calibrate and the C statistic was calculated to evaluate the association between predicted probabilities and observed proportions in the logistic regression model. RESULTS: Prevalence of successful weaning in the sample was 83.7%. There was no difference in mortality between elderly and non-elderly subjects (P = .16), in days of mechanical ventilation (P = .22) and days of weaning (P = .55). In elderly subjects, the IWI was the only respiratory variable associated with mechanical ventilation weaning in this population (P < .001). CONCLUSIONS: The IWI was the independent variable found in weaning of elderly subjects that may contribute to the critical moment of this population in intensive care.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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