Incidence and Risk Factors for Invasive Mechanical Ventilation Dependency in Japan: A Nationwide Retrospective Cohort Study.

Authors

Hiroyuki Ohbe, Monique Daniels, Daisuke Kudo, Hiroki Matsui, Stef Groenewoud, Werner Brouwer, Hideo Yasunaga

Published in

Journal of intensive care medicine. Pages 8850666261469500. Sep 03, 2026. Epub Sep 03, 2026.

Abstract

ObjectivesTo describe the incidence and risk factors for becoming dependent on invasive mechanical ventilation (IMV) in Japan.DesignRetrospective cohort study using a nationwide inpatient database from April 1, 2014, to March 31, 2020.SettingMore than 1500 acute care hospitals participating in the Diagnosis Procedure Combination Study Group Database, covering approximately 50% of all hospitalizations in acute care hospitals in Japan.PatientsAdults (≥18 years), in whom IMV was initiated during hospitalization. IMV-dependency was defined as discharge while still receiving IMV after ≥7 days and having undergone tracheostomy during hospitalization.InterventionsNone.Measurements And Main ResultsOf the 388,752 patients in whom IMV was initiated, 7805 (2.0%) became IMV dependent. In-hospital mortality occurred in 138,111 (35.5%) patients, and 242,836 (62.5%) were discharged without IMV dependency. The incidence of IMV dependency increased over time, from 1.6% in 2014 to 2.4% in 2019. Patients who became IMV dependent had a mean age of 71.3 years, and 49% were ≥75 years. Emergency admissions accounted for 91.7% of cases, and 68.1% presented with impaired consciousness at admission. In multinomial regression analysis (reference: discharged alive without IMV dependency), older age (≥75 years; RRR 1.48, 95% CI 1.41-1.56), impaired consciousness at admission (RRR 1.75, 95% CI 1.63-1.88), emergency admission (RRR 2.18, 95% CI 1.97-2.42), and surgery prior to IMV (RRR 1.92, 95% CI 1.82-2.03) were independently associated with IMV dependency.ConclusionsThe incidence of IMV dependency increased over time. Identified risk factors may inform clinical decision-making and advance care planning.

PMID:
42690837
Bibliographic data and abstract were imported from PubMed on 04 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.