Patient selection: adults on an internal medicine ward (non-ICU) receiving mechanical ventilation
The most important predictor of mortality was the acute physiology score (APS) of the APACHE II score (30.02.01) on the day of intubation (within 24 hours).
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APS on Day of Intubation
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Mortality Rate
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> 90
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10 times higher
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> 80
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5 times higher
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Additional factors associated with increased mortality:
(1) low serum albumin (median 2.98 g/dL in survivors, 2.57 in nonsurvivors)
(2) older age
(3) hypotension (mean arterial blood pressure <= 64 mm Hg)
(4) deterioriation in renal function at 72 hours after intubation
(5) intubation for a non-cardiac cause
(6) elevated total serum bilirubin
Limitations:
• Some patients may have been treated on the wards because space was not available in the ICU.
• Some patients may have been treated on the wards because they were terminally-ill and ICU admission was not considered appropriate.
• Several of the risk factors reflect multi-organ failures.
