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by ivanonymous
2253 days ago
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That ~90% figure is wildly misleading. It's based on 282 deaths among the 320 ventilated patients who either died or were discharged. But 831 patients were still on ventilators! It's a snapshot taken too soon. Estimates of mortality on vents very widely still, partly because of real underlying variation in practices or population, partly because the data is really messy. This email series from Mass General is a good orientation (discusses this study, links to discussions of previous studies):
https://mailchi.mp/db30d9d2cb24/tz4idnzryr-4406129?e=acf498e... Any vent strategy being debated on Twitter (early! late! APRV!) is also being discussed by working pulmonary critical care docs. Judging those discussions or the variations in practice as an outsider is hard. But relative silence on Twitter doesn't equal mindless orthodoxy. |
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> Fifth, clinical outcome data were available for only 46.2% of admitted patients. The absence of data on patients who remained hospitalized at the final study date may have biased the findings, including the high mortality rate of patients who received mechanical ventilation older than age 65 years.
MedPageToday notes this, but unlike the study, they start with the headline of 90% mortality, and don't mention until the very last sentence "that clinical outcome data were only available for less than half of admitted patients." This just seems wildly irresponsible reporting; I don't know if the reporter didn't really understand the limitations, or what, but at the very least, that should not have been the headline, not without a major proviso included at the very beginning.