Development and validation of a mechanical power-oriented prediction model of weaning failure in mechanically ventilated patients: a retrospective cohort study
Objective To develop and validate a mechanical power (MP)-oriented prediction model of weaning failure in mechanically ventilated patients.Design A retrospective cohort study.Setting Data were collected from the large US Medical Information Mart for Intensive Care-IV (MIMIC-IV) V.1.0, which integrat...
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| Format: | Article |
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BMJ Publishing Group
2022-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/12/e066894.full |
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| author | Zhiqiang Du Yanli Wang Yao Yan Xiaobing Chen Xiaomin Li Jiye Luo Yongpeng Xie |
| author_facet | Zhiqiang Du Yanli Wang Yao Yan Xiaobing Chen Xiaomin Li Jiye Luo Yongpeng Xie |
| author_sort | Zhiqiang Du |
| collection | DOAJ |
| description | Objective To develop and validate a mechanical power (MP)-oriented prediction model of weaning failure in mechanically ventilated patients.Design A retrospective cohort study.Setting Data were collected from the large US Medical Information Mart for Intensive Care-IV (MIMIC-IV) V.1.0, which integrates comprehensive clinical data from 76 540 intensive care unit (ICU) admissions from 2008 to 2019.Participants A total of 3695 patients with invasive mechanical ventilation for more than 24 hours and weaned with T-tube ventilation strategies were enrolled from the MIMIC-IV database.Primary and secondary outcome Weaning failure.Results All eligible patients were randomised into development cohorts (n=2586, 70%) and validation cohorts (n=1109, 30%). Multivariate logistic regression analysis of the development cohort showed that positive end-expiratory pressure, dynamic lung compliance, MP, inspired oxygen concentration, length of ICU stay and invasive mechanical ventilation duration were independent predictors of weaning failure. Calibration curves showed good correlation between predicted and observed outcomes. The prediction model showed accurate discrimination in the development and validation cohorts, with area under the receiver operating characteristic curve values of 0.828 (95% CI: 0.812 to 0.844) and 0.833 (95% CI: 0.809 to 0.857), respectively. Decision curve analysis indicated that the predictive model was clinically beneficial.Conclusion The MP-oriented model of weaning failure accurately predicts the risk of weaning failure in mechanical ventilation patients and provides valuable information for clinicians making decisions on weaning. |
| format | Article |
| id | doaj-art-77f56cb6d9ce45e1a4ab45907c441b14 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-12-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-77f56cb6d9ce45e1a4ab45907c441b142025-08-20T02:14:26ZengBMJ Publishing GroupBMJ Open2044-60552022-12-01121210.1136/bmjopen-2022-066894Development and validation of a mechanical power-oriented prediction model of weaning failure in mechanically ventilated patients: a retrospective cohort studyZhiqiang Du0Yanli Wang1Yao Yan2Xiaobing Chen3Xiaomin Li4Jiye Luo5Yongpeng Xie6Department of Critical Care Medicine, The Second People’s Hospital of Lianyungang, Lianyungang, Jiangsu, ChinaDepartment of Nutrition and Food Hygiene, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China2Biotheus Inc., Zhuhai, China3 Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, Jiangsu, China3 Department of Rheumatology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, ChinaDepartment of Emergency Medicine, The First People’s Hospital of Lianyungang, Lianyungang, Jiangsu, ChinaDepartment of Emergency Medicine, The First People’s Hospital of Lianyungang, Lianyungang, Jiangsu, ChinaObjective To develop and validate a mechanical power (MP)-oriented prediction model of weaning failure in mechanically ventilated patients.Design A retrospective cohort study.Setting Data were collected from the large US Medical Information Mart for Intensive Care-IV (MIMIC-IV) V.1.0, which integrates comprehensive clinical data from 76 540 intensive care unit (ICU) admissions from 2008 to 2019.Participants A total of 3695 patients with invasive mechanical ventilation for more than 24 hours and weaned with T-tube ventilation strategies were enrolled from the MIMIC-IV database.Primary and secondary outcome Weaning failure.Results All eligible patients were randomised into development cohorts (n=2586, 70%) and validation cohorts (n=1109, 30%). Multivariate logistic regression analysis of the development cohort showed that positive end-expiratory pressure, dynamic lung compliance, MP, inspired oxygen concentration, length of ICU stay and invasive mechanical ventilation duration were independent predictors of weaning failure. Calibration curves showed good correlation between predicted and observed outcomes. The prediction model showed accurate discrimination in the development and validation cohorts, with area under the receiver operating characteristic curve values of 0.828 (95% CI: 0.812 to 0.844) and 0.833 (95% CI: 0.809 to 0.857), respectively. Decision curve analysis indicated that the predictive model was clinically beneficial.Conclusion The MP-oriented model of weaning failure accurately predicts the risk of weaning failure in mechanical ventilation patients and provides valuable information for clinicians making decisions on weaning.https://bmjopen.bmj.com/content/12/12/e066894.full |
| spellingShingle | Zhiqiang Du Yanli Wang Yao Yan Xiaobing Chen Xiaomin Li Jiye Luo Yongpeng Xie Development and validation of a mechanical power-oriented prediction model of weaning failure in mechanically ventilated patients: a retrospective cohort study BMJ Open |
| title | Development and validation of a mechanical power-oriented prediction model of weaning failure in mechanically ventilated patients: a retrospective cohort study |
| title_full | Development and validation of a mechanical power-oriented prediction model of weaning failure in mechanically ventilated patients: a retrospective cohort study |
| title_fullStr | Development and validation of a mechanical power-oriented prediction model of weaning failure in mechanically ventilated patients: a retrospective cohort study |
| title_full_unstemmed | Development and validation of a mechanical power-oriented prediction model of weaning failure in mechanically ventilated patients: a retrospective cohort study |
| title_short | Development and validation of a mechanical power-oriented prediction model of weaning failure in mechanically ventilated patients: a retrospective cohort study |
| title_sort | development and validation of a mechanical power oriented prediction model of weaning failure in mechanically ventilated patients a retrospective cohort study |
| url | https://bmjopen.bmj.com/content/12/12/e066894.full |
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