Age and the Length of Hospital Stay in Patients With Sepsis at the ICU Admission can Prolong the Duration of Endotracheal Intubation

Background: Endotracheal intubation (EI) associated with mechanical ventilation (MV) is frequently performed in critically ill patients admitted to intensive care unit (ICU) with sepsis. Objectives: This study aimed to assess the impact of important factors on the duration of tracheal intubation in patients with sepsis at the ICU admission. Methods: Adult patients admitted to the mixed medical–surgical ICUs with sepsis at the ICU admission who needs prolonged mechanical ventilation (PMV) (≥ ۲۱ days) were included in this retrospective secondary analysis study. The primary outcome was ICU mortality. Baseline demographic and clinical characteristics of all patients were assessed as risk factors associated with the duration of MV by univariate and multivariate Binary logistic regression. Results: Eighty-five patients required more than ۲۱ days of MV. Out of the ۸۵ patients, ۵۲ (۶۱.۲%) patients were intubated within ۳۰ to ۳۴.۵۰ days and ۳۳ (۳۸.۸%) patients had intubation within ۳۴.۵۱ to ۶۵ days, and categorized as PMV and very prolonged MV groups, respectively. Two parameters were significantly associated with very prolonged MV which are as follows: older age ۱.۲۲۹ (۹۵% CI: ۱.۰۰۲-۱.۵۰۷, P = ۰.۰۴۸) and long hospital stay (LOS) ۲.۹۹۶ (۹۵% CI: ۱.۶۷۶-۵.۳۵۶, P < ۰.۰۰۱). No significant survival difference was observed between the two groups of study. (۳۳.۳% vs. ۲۵%, P = ۰.۴۰۶). Conclusion: Our observations showed that the older age and LOS as pre-ICU stay in patients with positive sepsis at the ICU admission can prolong the duration of intubation. In addition, no significant survival difference was observed between patients with PMV and very prolonged MV.

Keywords:

Sepsis , Intensive Care Unit , Endotracheal Intubation , Prolonged Mechanical Ventilation