A simple tool to predict an individual's five-year risk of requiring life support with mechanical ventilation has been developed by researchers. The study may assist physicians in facilitating discussions around advanced care planning with patients and their families.
"We anticipate that a tool that improves the identification of people who are at risk for needing life support will allow for better communication between patients, family and physicians regarding patient wishes should these patients become incapacitated by critical illness," explained corresponding author Allan Walkey, assistant professor at Boston University School of Medicine in the US.
"Improved early communication may lead to later care more in-line with patient wishes, increasing patient autonomy and improving our ability to care for patients," Walkey noted.
The need for mechanical ventilation during critical illness represents an event of significant short- and long-term consequence. Patients requiring mechanical ventilation have approximately 30 percent hospital mortality rates, a substantial risk of near-term death. The study used data from the Framingham Heart Study, focusing on participants aged 65 years or older.
The researchers assigned points to factors that were found to be strongly associated with needing life support, including older age, male gender, diabetes, hypertension, atrial fibrillation, moderate to severe alcohol use, chronic pulmonary disease and hospitalization within the prior year. They then developed a scoring system to estimate the probability of needing life support within a five-year period. The study appeared in Journal of the American Geriatric Society