| アブストラクト | ObjectivesTo describe the incidence and risk factors for becoming dependent on invasive mechanical ventilation (IMV) in Japan.DesignRetrospective cohort study using a nationwide inpatient database from April 1, 2014, to March 31, 2020.SettingMore than 1500 acute care hospitals participating in the Diagnosis Procedure Combination Study Group Database, covering approximately 50% of all hospitalizations in acute care hospitals in Japan.PatientsAdults (>/=18 years), in whom IMV was initiated during hospitalization. IMV-dependency was defined as discharge while still receiving IMV after >/=7 days and having undergone tracheostomy during hospitalization.InterventionsNone.Measurements And Main ResultsOf the 388,752 patients in whom IMV was initiated, 7805 (2.0%) became IMV dependent. In-hospital mortality occurred in 138,111 (35.5%) patients, and 242,836 (62.5%) were discharged without IMV dependency. The incidence of IMV dependency increased over time, from 1.6% in 2014 to 2.4% in 2019. Patients who became IMV dependent had a mean age of 71.3 years, and 49% were >/=75 years. Emergency admissions accounted for 91.7% of cases, and 68.1% presented with impaired consciousness at admission. In multinomial regression analysis (reference: discharged alive without IMV dependency), older age (>/=75 years; RRR 1.48, 95% CI 1.41-1.56), impaired consciousness at admission (RRR 1.75, 95% CI 1.63-1.88), emergency admission (RRR 2.18, 95% CI 1.97-2.42), and surgery prior to IMV (RRR 1.92, 95% CI 1.82-2.03) were independently associated with IMV dependency.ConclusionsThe incidence of IMV dependency increased over time. Identified risk factors may inform clinical decision-making and advance care planning. |
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| ジャーナル名 | Journal of intensive care medicine |
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| Pubmed追加日 | 2026/9/3 |
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| 投稿者 | Ohbe, Hiroyuki; Daniels, Monique; Kudo, Daisuke; Matsui, Hiroki; Groenewoud, Stef; Brouwer, Werner; Yasunaga, Hideo |
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| 組織名 | Department of Emergency and Critical Care Medicine, Tohoku University Hospital,;Sendai, Japan. RINGGOLD: 13101;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan. RINGGOLD: 13143;Erasmus School of Health Policy & Management, Erasmus University Rotterdam,;Rotterdam, the Netherlands. RINGGOLD: 6984;Division of Emergency and Critical Care Medicine, Tohoku University Graduate;School of Medicine, Sendai, Miyagi, Japan.;Radboud Institute for Health Sciences / Scientific Center for Quality of;Healthcare (IQ Healthcare), Radboud University Medical Center, Nijmegen, the;Netherlands. RINGGOLD: 6034 |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/42690837/ |
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