Prevalence, Clinical Characteristics, and Outcomes of Intensive Care Unit Patients Requiring Prolonged Mechanical Ventilation in a Tertiary Hospital in the Philippines: A Single-Center Retrospective Cross-sectional Study

Abstract

Background and Objective. Epidemiology data on prolonged mechanical ventilation (PMV) and PMV patient features in the Philippines is lacking. This retrospective cross-sectional study aimed to determine the prevalence of PMV among intubated patients, describe patient characteristics and outcomes, and identify risk factors associated with PMV.

Methods. A retrospective review of records was done on adult intubated patients admitted under the Medical Intensive Care Unit Service from July 2022 to June 2023. Various clinical characteristics and outcomes of PMV and non-PMV patients were collected, compared, and analyzed. PMV was defined as having MV for ≥6 hours per day for >21 days.

Results. Among 261 intubated ICU patients admitted, 75 (28.7%) required PMV. PMV patients were older (62 vs. 53.5), had higher Charlson Comorbidity Index scores (4 vs. 3), and required vasopressors (81.33% vs. 54.84%) and blood products (93.33% vs. 51.08%) more often. Nosocomial infections (86.67% vs. 45.70%), ventilatorrelated (30.67% vs. 12.37%) and in-hospital (66.22% vs. 32.97%) complications developed more frequently. Outcomes such as ICU length of stay (29.5 vs. 7 days) and hospital mortality (61.33% vs. 41.94%) were longer. Vasopressor use (OR 2.25, 95% CI 1.06-4.76), development of nosocomial infections (OR 6.20, 95% CI 2.6414.56), and development of in-hospital-related complications (OR 2.20, 95% CI 1.13-4.30) were independent predictors of PMV.

Conclusion. In this single-center investigation, 28.7% of ICU patients required PMV. Knowledge of patient characteristics and risk factors aid in the development of interventions that improve outcomes and reduce PMV prevalence. Larger studies are recommended to assess nationwide PMV epidemiology and provide data on the need for step-down units for weaning.