Modification of the prolonged mechanical ventilation prognostic model score to predict short‐term and 1‐year mortalities

ABSTRACT Background and objective We aimed to validate the use of the Prolonged Mechanical Ventilation Prognostic Model (ProVent) score in medically ill patients with co‐morbidities and to modify the score to improve the prediction power of 1‐year mortality. Methods We conducted a retrospective study of all patients who required at least 14 days of mechanical ventilation (MV) and established two groups (14–20 and ≥21 days of MV) based on the MV duration. We performed external validation of the present ProVent Model in our patients on Day 14 (or Day 21 for the ≥21‐day MV group) of MV, and established the extended ProVent model, while considering the albumin and bilirubin levels and co‐morbidities (chronic obstructive pulmonary disease and cancer). Results A total of 1288 patients (666 and 622 with 14–20 and ≥21 days of MV, respectively) with at least 14 days of MV were enrolled. The 1‐year mortality was 79.9% and 78.7% in the ≥21‐ and 14–20‐day groups, respectively. Most of the observed mortality rates in all groups were within the 95% CI of predicted mortality as per the ProVent Model, except for the ProVent scores of 0 and 5. In the ProVent model, the area under the curve for the prediction of 1‐year mortality was 0.69 in all patients with ≥14 days of MV, whereas in the extended ProVent model, the area under the curve was 0.89. Conclusion The extended ProVent model, which considers co‐morbidities and laboratory data, increases the prediction power of 1‐year mortality in patients who require prolonged MV.