The following is a summary of “Factors Associated With Initiation of Mechanical Ventilation in Patients With Sepsis: Retrospective Observational Study,” published in the September 2023 issue of Critical Care by Freundlich et al.
Due to sepsis-induced respiratory failure, patients with the condition are at risk for requiring mechanical ventilation.
Researchers conducted a retrospective study to identify time-dependent risk factors for mechanical ventilation in patients with sepsis.
They utilized electronic health record data to model risk factors for initiating mechanical ventilation following sepsis onset, employing a time-varying Cox model to examine changed factors.
The results showed 35,020 patients meeting sepsis criteria, and 28,747 (82%) qualified for inclusion. Mechanical ventilation was conducted 30 days after sepsis onset in 3,891 patients (13.5%). Factors independently linked with an increased likelihood of receiving mechanical ventilation included race (White: adjusted HR, 1.59; 95% CI, 1.39-1.83; other: adjusted HR, 1.97; 95% CI, 1.54-2.52), systemic inflammatory response syndrome (revised HR, 1.23; 95% CI, 1.17-1.28), Sequential Organ Failure Assessment score (adjusted HR, 1.28; 95% CI, 1.26-1.31), and congestive heart failure (changed HR, 1.30; 95% CI, 1.17-1.45). HR for Sequential Organ Failure Assessment score and congestive heart failure decreased with time, while those for 4 comorbidities and 3 culture results varied with time.
Investigators concluded that the temporal association between various risk factors and mechanical ventilation in sepsis varied, suggesting the potential for personalized intervention strategies.
