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Updated: Feb 5, 2026
Mechanical Ventilation Boot Camp Curriculum
Published on: March 12, 2018
Modification of the prolonged mechanical ventilation prognostic model score to predict short-term and 1-year
Yu Rang Park1, Ji Sung Lee2, Hwa Jung Kim3
1Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea.
Background And Objective:
We aimed to validate the use of the Prolonged Mechanical Ventilation Prognostic Model (ProVent) score in medically ill patients with co-morbidities and to modify the score to improve the prediction power of 1-year mortality.
Methods:
We conducted a retrospective study of all patients who required at least 14 days of mechanical ventilation (MV) and established two groups (14-20 and ≥21 days of MV) based on the MV duration. We performed external validation of the present ProVent Model in our patients on Day 14 (or Day 21 for the ≥21-day MV group) of MV, and established the extended ProVent model, while considering the albumin and bilirubin levels and co-morbidities (chronic obstructive pulmonary disease and cancer).
Results:
A total of 1288 patients (666 and 622 with 14-20 and ≥21 days of MV, respectively) with at least 14 days of MV were enrolled. The 1-year mortality was 79.9% and 78.7% in the ≥21- and 14-20-day groups, respectively. Most of the observed mortality rates in all groups were within the 95% CI of predicted mortality as per the ProVent Model, except for the ProVent scores of 0 and 5. In the ProVent model, the area under the curve for the prediction of 1-year mortality was 0.69 in all patients with ≥14 days of MV, whereas in the extended ProVent model, the area under the curve was 0.89.
Conclusion:
The extended ProVent model, which considers co-morbidities and laboratory data, increases the prediction power of 1-year mortality in patients who require prolonged MV.
Insights
The enhanced ProVent model improves 1-year mortality prediction in prolonged mechanical ventilation (MV) patients. This modified score incorporates comorbidities and lab data for better accuracy in critically ill individuals requiring extended MV support.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Prognostic Modeling
Background:
- Prolonged mechanical ventilation (MV) is associated with high mortality.
- Existing prognostic models may not fully capture outcomes in complex patient populations.
- Validation and refinement of prognostic tools are crucial for clinical decision-making.
Purpose of the Study:
- To validate the Prolonged Mechanical Ventilation Prognostic Model (ProVent) in medically ill patients with comorbidities.
- To modify the ProVent score to enhance its predictive power for 1-year mortality.
- To assess the impact of comorbidities and laboratory data on mortality prediction in prolonged MV.
Main Methods:
- Retrospective study of 1288 patients requiring at least 14 days of MV.
- External validation of the ProVent model at Day 14 (or Day 21).
- Development of an extended ProVent model incorporating albumin, bilirubin, COPD, and cancer.
Main Results:
- 1-year mortality was high (79.9% and 78.7%) in groups with ≥21 and 14-20 days of MV, respectively.
- The original ProVent model showed moderate predictive power (AUC 0.69).
- The extended ProVent model significantly improved 1-year mortality prediction (AUC 0.89).
Conclusions:
- The extended ProVent model demonstrates superior prediction of 1-year mortality.
- Incorporating comorbidities and laboratory data enhances prognostic accuracy for prolonged MV patients.
- The modified ProVent score offers a more precise tool for risk stratification in this population.
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