APACHE II score cannot predict successful weaning from prolonged mechanical ventilation

At least 5% of all intensive care unit patients require prolonged respiratory support. Multiple factors have been suggested as possible predictors of successful respiratory weaning so far. We sought to verify whether the Acute Physiology and Chronic Health Evaluation II (APACHE II) can predict freed...

Full description

Saved in:
Bibliographic Details
Published in:Chronic respiratory disease 2017-08, Vol.14 (3), p.270-275
Main Authors: Rojek-Jarmuła, Anna, Hombach, Rainer, Krzych, Łukasz J
Format: Article
Language:English
Subjects:
Aged
APACHE
Area Under Curve
Continuous Positive Airway Pressure
Female
Humans
Intermittent Positive-Pressure Ventilation
Male
Middle Aged
Original Papers
Ostomy
Predictive Value of Tests
Respiratory failure
Respiratory Insufficiency - etiology
Respiratory Insufficiency - therapy
Retrospective Studies
ROC Curve
Tracheostomy
Tracheotomy
Ventilator Weaning
Ventilators
Weaning
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:At least 5% of all intensive care unit patients require prolonged respiratory support. Multiple factors have been suggested as possible predictors of successful respiratory weaning so far. We sought to verify whether the Acute Physiology and Chronic Health Evaluation II (APACHE II) can predict freedom from prolonged mechanical ventilation (PMV) in patients treated in a regional weaning centre. The study group comprised 130 consecutive patients (age; median (interquartile range): 71 (62–77) years), hospitalized between 1 January 2012, and 31 December 2013. APACHE II score was assessed based on the worst values taken during the first 24 hours after admission. Glasgow coma scale was excluded from calculations due to the likely influence of sedative agents. The outcome was defined as freedom from mechanical ventilation, with or without tracheostomy on discharge. Among survivors (n = 115), 88.2% were successfully liberated from mechanical ventilation and 60.9% from tracheostomy. APACHE II failed to predict freedom from mechanical ventilation (area under the receiver–operating characteristic curve [AUROC] = 0.534; 95% confidence interval [CI]: 0.439–0.628; p = 0.65) and tracheostomy tube removal (AUROC = 0.527; 95% CI: 0.431–0.621; p = 0.63). Weaning outcome was unrelated to the aetiology of respiratory failure on admission (p = 0.41). APACHE II cannot predict weaning outcome in patients requiring PMV.
ISSN:1479-9731
1479-9723
1479-9731
DOI:10.1177/1479972316687100