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Evaluate the prognostic factors associated with mortality in patients undergoing mechanical ventilation in the emergency department.

June 10, 2026Open Access

Prognostic Factors of Mechanical Ventilation Mortality in the Emergency Department; a Retrospective Cross-Sectional Study

Key Points

Evaluate the prognostic factors associated with mortality in patients undergoing mechanical ventilation in the emergency department.
Retrospective cross-sectional study of patients over 18 who underwent mechanical ventilation in an emergency department.
Statistical analyses including univariate and multivariate logistic regression and Kaplan-Meier survival curves.
Data collected from 430 patients between August 2022 and September 2023 in Tehran, Iran.
identified cancer (OR = 0.13, P = 0.019) as a significant predictor of mortality.
Oxygenation failure predicted mortality with OR = 0.32 (P = 0.03); and vasopressor usage showed strong association with mortality (OR = 0.07, P < 0.001).
Lower systolic blood pressure (OR = 1.03, P = 0.035), lower platelet count (OR = 0.99, P = 0.042), and lower PCO2 levels (OR = 0.95, P = 0.013) also indicated increased mortality risk.

Abstract

Background: Mechanical ventilation in emergency departments (ED) is crucial to airway management. Various factors significantly influence patient outcomes. Objectives: This study aimed to evaluate the prognostic factors of mortality in patients undergoing mechanical ventilation in the ED. Methods: This retrospective cross-sectional study examined patients over 18 who underwent mechanical ventilation in the ED of a referral hospital in Tehran, Iran, between August 2022 and September 2023. The association between patients’ characteristic and intubation-related parameters with in-hospital mortality was measured using univariate and multivariate logistic regression, as well as Kaplan-Meier survival curve analyses. Results: We examined 430 patients with a mean age of 61.4 ± 22.0 (range: 18-103) years were studied (60.7% male). There was significant correlation between in-hospital mortality and age (P < 0.01); cancer (P = 0.002) and hypothyroidism (P = 0.009) as the underlying diseases; failure to protect airway (P = 0.27) and oxygenation failure (P = 0.04) as the causes of intubation; vasopressors usage (P < 0.001); medications which were used for rapid sequence intubation (P < 0.001); systolic blood pressure (P < 0.01) and diastolic blood pressure (P < 0.01); time to intubation (P = 0.006); platelet count (P < 0.001) and hemoglobin level (P= 0.003); and finally HCO3 (P = 0.05) and PCO2 levels (P = 0.013). Multivariate logistic regression analysis identified cancer (P = 0.019, OR = 0.13), oxygenation failure (P = 0.03, OR = 0.32), vasopressor medication (P < 0.001, OR = 0.07), systolic blood pressure (P = 0.035, OR = 1.03), platelet count (P = 0.042, OR = 0.99), and PCO2 (P = 0.013, OR = 0.95) as independent predictive factors of mortality rate. Conclusion: This study identified several predictive factors of mortality in patients undergoing mechanical ventilation in the ED, including cancer, oxygenation failure, use of vasopressors, lower systolic blood pressure, lower platelet count, and lower PCO2.

Prognostic Factors of Mechanical Ventilation Mortality in the Emergency Department; a Retrospective Cross-Sectional Study

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