The Integrative Weaning Index in Elderly ICU Subjects

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. (C) 2017 Daedalus Enterprises