Cooke et al measured the survival of terminal patients following withdrawal of mechanical ventilation in the intensive care unit (ICU). They identified factors which may help to prepare family members for a delay in death. The authors are from the University of Michigan, the Oregon Clinic in Portland, the University of Washington in Seattle and the Department of Health and Human Services.


Patient selection: withdrawal of mechanical ventilation associated with terminal status in adults (median age 71 with interquartile range 58 to 80 years).


Time from Termination of Mechanical Ventilation

Percent Survival

1 hour

45% (55% mortality)

6 hours


12 hours


24 hours


48 hours

< 1%

after Figure 2 page 292


Factors associated with shorter survival:

(1) nonwhite race (HR 1.2)

(2) number of organ failures (HR 1.1 per organ failure)

(3) use of vasopressors during the 4 days prior to withdrawal (HR 1.7)

(4) delivery of intravenous fluids during the 4 days prior to withdrawal (HR 1.2)

(5) surgical patient (vs medical, HR 1.3)

(6) younger age (HR 0.95 per decade)

(7) male gender (HR 1.0 vs 0.86 for females)



• The risk for age is given as 0.95 per decade/ The precise age range is vague but the interquartile range is given as 58 to 81 years of age. The baseline HR at 58 years would be 1.0, so the HR should be based on each decade after that age.



• None of the hazard ratios are significantly large.


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