INVESTIGATING THE IMPACT OF AGE ON OUTCOME OF MECHANICAL VENTILATION USING A POPULATION OF 41,848 PATIENTS FROM A STATEWIDE DATABASE

Study objective: To examine the impact of age on outcome from mechanic al ventilation. Design: Retrospective analysis of a statewide database . Setting: All acute-care hospitals in New York State. Patients: All p atients, aged 18 years and over, requiring mechanical ventilation duri ng 1990 who could be identified with a mechanical ventilation procedur e code (93.92) were studied. Data were obtained in aggregate form (six or more cases) from the New York State Department of Health. This pro cess required a detailed request letter to the Statewide Planning and Cooperative System (SPARCS). Transmission of confidential information was not desired or permitted. Measurements and results: Age and mortal ity rate (MR) fit a cuboidal regression model best (MR= -25.55+ 3.98Ag e-0.072Age(2)+0.00043Age(3), R(2)=0.85). Mortality rates vary signific antly across various broad diagnostic groups (p<0.01, analysis of vari ance [ANOVA]) and increase as a function of ICU duration (p<0.01, ANOV A). Conclusions: Age has an important effect on outcome from mechanica l ventilation. Other factors, such as ICU duration and diagnosis, also influence outcome, and age should not be used as a sole criterion in evaluating the potential benefit of mechanical ventilation to an indiv idual patient. Large, existing databases, such as SPARCS, may be usefu l in studying the application of mechanical ventilation.