Development and validation of a model for predicting prolonged weaning from mechanical ventilation in patients with abdominal trauma

Fengchan Xi ¹, Chuanrui Sun ², Weiwei Ding ³

⁰Department of Intensive Care Unit, Nanjing Women and Children's Healthcare Hospital, Women's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China; Research Institute of General Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.

Surgery +

|

August 21, 2024

View abstract on PubMed

Summary

This study developed a predictive model for prolonged mechanical ventilation weaning in abdominal trauma patients. The model accurately identifies high-risk individuals, improving respiratory management and predicting outcomes.

Area Of Science

Critical Care Medicine
Respiratory Therapy
Trauma Surgery

Background

Prolonged mechanical ventilation poses significant risks for patients with abdominal trauma.
Effective prediction of weaning difficulty is crucial for optimizing patient care and outcomes.

Purpose Of The Study

To develop and validate a predictive model for prolonged weaning from mechanical ventilation in patients with abdominal trauma.
To identify key predictors of prolonged weaning and associated clinical outcomes.

Main Methods

A predictive model was constructed using data from 190 abdominal trauma patients, divided into training and validation cohorts.
Predictive factors were identified using logistic regression and validated with ROC, calibration, and decision curve analyses.
Clinical outcomes, including 28-day mortality, were compared between risk groups.

Main Results

Six factors (APACHE II, ISS, GCS, total bilirubin, skeletal muscle index, abdominal fat index) were included in the final model.
The model demonstrated good discrimination, excellent calibration, and favorable net benefit.
High-risk patients had significantly higher rates of prolonged weaning and 28-day mortality.

Conclusions

A validated model accurately predicts prolonged weaning risk in abdominal trauma patients.
Skeletal muscle index is an independent risk factor for prolonged weaning.
The model provides valuable insights for respiratory management and outcome prediction in this patient population.