The Integrative Weaning Index in Elderly ICU Subjects

Respir Care. 2017 Mar;62(3):333-339. doi: 10.4187/respcare.04524. Epub 2016 Nov 29.

Abstract

Background: With increasing life expectancy and ICU admission of elderly patients, mechanical ventilation, and weaning trials have increased worldwide.

Methods: We evaluated a cohort with 479 subjects in the ICU. Patients younger than 18 y, tracheostomized, or with neurologic diseases were excluded, resulting in 331 subjects. Subjects ≥70 y old were considered elderly, whereas those <70 y old were considered non-elderly. Besides the conventional weaning indexes, we evaluated the performance of the integrative weaning index (IWI). The probability of successful weaning was investigated using relative risk and logistic regression. The Hosmer-Lemeshow goodness-of-fit test was used to calibrate and the C statistic was calculated to evaluate the association between predicted probabilities and observed proportions in the logistic regression model.

Results: Prevalence of successful weaning in the sample was 83.7%. There was no difference in mortality between elderly and non-elderly subjects (P = .16), in days of mechanical ventilation (P = .22) and days of weaning (P = .55). In elderly subjects, the IWI was the only respiratory variable associated with mechanical ventilation weaning in this population (P < .001).

Conclusions: The IWI was the independent variable found in weaning of elderly subjects that may contribute to the critical moment of this population in intensive care.

Keywords: elderly; mechanical ventilation; weaning.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Critical Care / methods
  • Female
  • Geriatric Assessment / methods*
  • Humans
  • Intensive Care Units
  • Logistic Models
  • Male
  • Middle Aged
  • Models, Statistical*
  • Risk
  • Risk Assessment / methods
  • Severity of Illness Index*
  • Time Factors
  • Treatment Outcome
  • Ventilator Weaning / methods
  • Ventilator Weaning / statistics & numerical data*