Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor
To the Editor: In a large international study,
Dr Esteban and colleagues1 found a 28-day
survival rate of 69.3% among adult patients requiring mechanical ventilation.
Survival in the subset of patients with chronic obstructive pulmonary disease
(COPD) was 72%.
These outcomes are quite similar to the 75% survival rate that my colleagues
and Ireported in 1975,2 over a 10-year period
in a single intensive care unit. We found the death rate among patients with
COPD to be 79.8%. Of course, our study did not identify age, sex, or APACHE
III score (because it had not yet been defined). But the outcome in 1877 consecutive
patients ventilated for more than 12 hours, like the entry criteria of Esteban
et al,1 compare favorably with ours. It
is likely that the study of Esteban et al1
may have enrolled more severe patients, hence comparisons would be difficult.
Petty TL. Long-term Trends in Mortality in the Intensive Care Unit. JAMA. 2002;287(14):1805. doi:10.1001/jama.287.14.1799