Psychiatric patients' intensive care admission characteristics, weaning from mechanical ventilation and sedative drug use : A single center retrospective case-control study
Copyright © 2023 Elsevier Inc. All rights reserved..
PURPOSE: To describe the characteristics, treatment and outcome, in particular weaning from mechanical ventilation (MV), of critically ill Patients with prior psychiatric conditions (PPC).
METHODS: Single center, 6-year, retrospective study comparing critically ill PPC to randomly sex and age matched cohort without PPC (1:1 ratio). Main outcome measure- adjusted mortality rates. Secondary outcome measures- unadjusted mortality, rates of MV, extubation failure and amount/dose of pre-extubation sedatives/analgesics.
RESULTS: Included were 214 patients per group. PPC adjusted mortality rates were higher in the ICU (14.0% vs 4.7%; OR 3.058 [95%CI 1.380, 6.774]; p = 0.006) and in-hospital (26.6% vs 13.1%; OR 2.639 [95% CI 1.496, 4.655]; p = 0.001). PPC had higher MV rates (63.6% vs 51.4%; p = 0.011). These patients were more likely to have more than two weaning attempts (29.4% vs 10.9%; p < 0.001), more commonly treated with >2 sedative drugs in the 48-h pre-extubation (39.2% vs 23.3%; p = 0.026) and received more propofol in the 24-h pre-extubation. PPC were more likely to self-extubate (9.6% vs 0.9%; p = 0.004) and had lower likelihood of success in planned extubations (50.0% vs 76.4%; p < 0.001).
CONCLUSION: Critically ill PPC had higher mortality rates than their matched counterparts. They also had higher MV rates and were more difficult to wean.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:77 |
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| Enthalten in: |
Journal of critical care - 77(2023) vom: 15. Okt., Seite 154331 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Barel, Nevo [VerfasserIn] |
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| Links: |
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| Themen: |
Critical illness |
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| Anmerkungen: |
Date Completed 07.08.2023 Date Revised 07.08.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jcrc.2023.154331 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM357191854 |
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| 100 | 1 | |a Barel, Nevo |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Psychiatric patients' intensive care admission characteristics, weaning from mechanical ventilation and sedative drug use |b A single center retrospective case-control study |
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| 500 | |a Date Completed 07.08.2023 | ||
| 500 | |a Date Revised 07.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a PURPOSE: To describe the characteristics, treatment and outcome, in particular weaning from mechanical ventilation (MV), of critically ill Patients with prior psychiatric conditions (PPC) | ||
| 520 | |a METHODS: Single center, 6-year, retrospective study comparing critically ill PPC to randomly sex and age matched cohort without PPC (1:1 ratio). Main outcome measure- adjusted mortality rates. Secondary outcome measures- unadjusted mortality, rates of MV, extubation failure and amount/dose of pre-extubation sedatives/analgesics | ||
| 520 | |a RESULTS: Included were 214 patients per group. PPC adjusted mortality rates were higher in the ICU (14.0% vs 4.7%; OR 3.058 [95%CI 1.380, 6.774]; p = 0.006) and in-hospital (26.6% vs 13.1%; OR 2.639 [95% CI 1.496, 4.655]; p = 0.001). PPC had higher MV rates (63.6% vs 51.4%; p = 0.011). These patients were more likely to have more than two weaning attempts (29.4% vs 10.9%; p < 0.001), more commonly treated with >2 sedative drugs in the 48-h pre-extubation (39.2% vs 23.3%; p = 0.026) and received more propofol in the 24-h pre-extubation. PPC were more likely to self-extubate (9.6% vs 0.9%; p = 0.004) and had lower likelihood of success in planned extubations (50.0% vs 76.4%; p < 0.001) | ||
| 520 | |a CONCLUSION: Critically ill PPC had higher mortality rates than their matched counterparts. They also had higher MV rates and were more difficult to wean | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Critical illness | |
| 650 | 4 | |a Health services administration | |
| 650 | 4 | |a Mental disorders | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Respiration, artificial | |
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| 700 | 1 | |a Bdolach-Abraham, Tali |e verfasserin |4 aut | |
| 700 | 1 | |a Levin, Philip |e verfasserin |4 aut | |
| 700 | 1 | |a Einav, Sharon |e verfasserin |4 aut | |
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