Prevalence and intensive care bed use in patients on prolonged mechanical ventilation in Swedish intensive care units.

Background The number of patients requiring prolonged mechanical ventilation (PMV) is predicted to escalate due to an aging population. International studies on prevalence and resource utilization of this patient group exist, but data are lacking from Scandinavian intensive care units (ICUs) with a relatively low number of ICU beds in relation to population. The primary aim was to identify prevalence of admissions requiring mechanical ventilation ≥7–21 days and prolonged mechanical ventilation >21 days, and their use of intensive care unit (ICU) bed days in Sweden. Secondary aims were to describe patient characteristics and outcomes. Methods: We obtained admissions ≥18 years with mechanical ventilation ≥7 days from the Swedish Intensive Care Registry and used open source registry data for calculation of prevalence and use of bed days of admissions with mechanical ventilation ≥7–21 days and prolonged mechanical ventilation >21 days. Results: Of the 39,510 ICU admissions to Swedish ICUs in 2017, mechanical ventilation ≥7–21 days accounted for 1,643 (4%) admissions; prolonged mechanical ventilation >21 days for 307 (0.8%) admissions. Of the 109,457 ICU bed days, 22 % were consumed by admissions experiencing mechanical ventilation ≥7–21 days and 10% by prolonged mechanical ventilation >21 days. ICU-mortality of both mechanical ventilation ≥7–21 and >21 days admissions was 21%. Admissions with mechanical ventilation ≥7 days had a median age of 65 years, and were dominated by males (64%). Conclusions: Admissions to Swedish ICUs requiring mechanical ventilation ≥7–21days and prolonged mechanical ventilation >21 days, form a relatively small part of all ICU admissions but a significant part of ICU beds days. Prevalence of admissions, ICU bed days and ICU mortality were lower than reports from other countries, but predominated by elderly and male in accordance with other reports.