Prolonged Mechanical Ventilation in Critically Ill Stroke Patients Linked to Increased Mortality Rates

A recent study published in Neurotherapeutics has identified several risk factors for prolonged mechanical ventilation (PMV) in critically ill patients with ischemic stroke. The research, conducted by a team from the Department of Emergency at Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, found that patients with PMV had significantly higher in-hospital and one-year mortality rates compared to those not requiring PMV.

Key Takeaways:

• The study included 756 ischemic stroke patients, of whom 111 (14.7%) required PMV.
• Independent risk factors for PMV included:

+ BMI ≥ 33 kg/m² (OR 1.82, 95% CI 1.10-3.02)

+ COPD (OR 2.02, 95% CI 1.25-3.24)

+ pH 7.45 (OR 1.79, 95% CI 1.12-2.86)

+ Respiratory rate ≥ 20/min (OR 2.39, 95% CI 1.47-3.88)

+ Sepsis onset before D14 (OR 8.48, 95% CI 1.75-41.06)

+ Tracheostomy (OR 7.38, 95% CI 4.38-12.44)

+ Vasopressor use (OR 2.19, 95% CI 1.26-3.79)

+ Pneumonia onset before D14 (OR 1.68, 95% CI 1.01-2.79)

• The predictive model incorporating these factors showed good diagnostic performance, with an AUC of 0.86 (95% CI 0.83-0.89) and calibration (Hosmer-Lemeshow P = 0.149).

Statistics:

• 111 out of 756 patients (14.7%) required PMV
• In-hospital mortality rate for PMV patients was 27.0%
• One-year mortality rate for PMV patients was 45.9%
• AUC of the predictive model was 0.86 (95% CI 0.83-0.89)

Sources:

• "Risk factors for prolonged mechanical ventilation in critically ill patients with ischemic stroke" - Neurotherapeutics, 2025
• Neurotherapeutics - www.journals.elsevier.com/neurotherapeutics/
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