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Evolution of Mortality over Time in Patients Receiving Mechanical Ventilation

Esteban, Andrés, Frutos-Vivar, Fernando, Muriel, Alfonso, Ferguson, Niall D., Peñuelas, Oscar, Abraira, Victor, Raymondos, Konstantinos, Rios, Fernando, Nin, Nicolas, Apezteguía, Carlos, Violi, Damian A., Thille, Arnaud W., Brochard, Laurent, González, Marco, Villagomez, Asisclo J., Hurtado, Javier, Davies, Andrew R., Du, Bin, Maggiore, Salvatore M., Pelosi, Paolo, Soto, Luis, Tomicic, Vinko, D’Empaire, Gabriel, Matamis, Dimitrios, Abroug, Fekri, Moreno, Rui P., Soares, Marco Antonio, Arabi, Yaseen, Sandi, Freddy, Jibaja, Manuel, Amin, Pravin, Koh, Younsuck, Kuiper, Michael A., Bülow, Hans-Henrik, Zeggwagh, Amine Ali, Anzueto, Antonio·2013·American Journal of Respiratory and Critical Care Medicine

Abstract

RATIONALE: Baseline characteristics and management have changed over time in patients requiring mechanical ventilation; however, the impact of these changes on patient outcomes is unclear. OBJECTIVES: To estimate whether mortality in mechanically ventilated patients has changed over time. METHODS: Prospective cohort studies conducted in 1998, 2004, and 2010, including patients receiving mechanical ventilation for more than 12 hours in a 1-month period, from 927 units in 40 countries. To examine effects over time on mortality in intensive care units, we performed generalized estimating equation models. MEASUREMENTS AND MAIN RESULTS: We included 18,302 patients. The reasons for initiating mechanical ventilation varied significantly among cohorts. Ventilatory management changed over time (P < 0.001), with increased use of noninvasive positive-pressure ventilation (5% in 1998 to 14% in 2010), a decrease in tidal volume (mean 8.8 ml/kg actual body weight [SD = 2.1] in 1998 to 6.9 ml/kg [SD = 1.9] in 2010), and an increase in applied positive end-expiratory pressure (mean 4.2 cm H2O [SD = 3.8] in 1998 to 7.0 cm of H2O [SD = 3.0] in 2010). Crude mortality in the intensive care unit decreased in 2010 compared with 1998 (28 versus 31%; odds ratio, 0.87; 95% confidence interval, 0.80-0.94), despite a similar complication rate. Hospital mortality decreased similarly. After adjusting for baseline and management variables, this difference remained significant (odds ratio, 0.78; 95% confidence interval, 0.67-0.92). CONCLUSIONS: Patient characteristics and ventilation practices have changed over time, and outcomes of mechanically ventilated patients have improved. Clinical trials registered with www.clinicaltrials.gov (NCT01093482).

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Metadata

Authors
Esteban, A., Frutos-Vivar, F., Muriel, A., Ferguson, N. D., Peñuelas, O., Abraira, V., Raymondos, K., Rios, F., Nin, N., Apezteguía, C., Violi, D. A., Thille, A. W., Brochard, L., González, M., Villagomez, A. J., Hurtado, J., Davies, A. R., Du, B., Maggiore, S. M., Pelosi, P., Soto, L., Tomicic, V., D’Empaire, G., Matamis, D., Abroug, F., Moreno, R. P., Soares, M. A., Arabi, Y., Sandi, F., Jibaja, M., Amin, P., Koh, Y., Kuiper, M. A., Bülow, H.-H., Zeggwagh, A. A., & Anzueto, A.
Venue
American Journal of Respiratory and Critical Care Medicine
Published
2013-07-15
Volume
188
Issue
2
Pages
220-230
ISSN
  • 1073-449X (ISSN-L)
  • 1535-4970
OpenAlex
W2031865625
Cited by
676
References
5
FWCI
43.36
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Evolution of Mortality over Time in Patients Receiving Mechanical Ventilation. https://app.cochat.ai/papers/10.1164/rccm.201212-2169oc
The paper
Esteban, A., Frutos-Vivar, F., Muriel, A., Ferguson, N. D., Peñuelas, O., Abraira, V., Raymondos, K., Rios, F., Nin, N., Apezteguía, C., Violi, D. A., Thille, A. W., Brochard, L., González, M., Villagomez, A. J., Hurtado, J., Davies, A. R., Du, B., Maggiore, S. M., . . . Anzueto, A. (2013). Evolution of Mortality over Time in Patients Receiving Mechanical Ventilation. American Journal of Respiratory and Critical Care Medicine. https://doi.org/10.1164/rccm.201212-2169oc

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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