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Research Letter |

Use of Mechanical Ventilation by Patients With and Without Dementia, 2001 Through 2011

Tara Lagu, MD, MPH1,2,3; Marya D. Zilberberg, MD, MPH4,5; Jennifer Tjia, MD, MSCE6; Penelope S. Pekow, PhD1,5; Peter K. Lindenauer, MD, MSc1,3
[+] Author Affiliations
1Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts
2Division of General Medicine, Baystate Medical Center, Springfield, Massachusetts
3Tufts University School of Medicine, Boston, Massachusetts
4EviMed Research Group, LLC, Goshen, Massachusetts
5School of Public Health and Health Sciences, University of Massachusetts-Amherst, Amherst
6Department of Medicine, University of Massachusetts Medical School, Worcester
JAMA Intern Med. 2014;174(6):999-1001. doi:10.1001/jamainternmed.2014.1179.
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Increasing demand for US critical care resources, including beds, intensivists, and invasive mechanical ventilation (IMV),1,2 has placed substantial strain on the critical care system. Since 2000, elderly patients treated in the intensive care unit have received higher intensity care (and have experienced lower mortality rates) than historical cohorts.3 Yet certain populations of elderly patients exposed to intensive care experience substantial long-term adverse effects, including functional decline and excess mortality. Patients with dementia receiving IMV, for example, are at high risk for delirium, which confers a 3.2-fold increased risk of 6-month mortality.4 The increasing use of aggressive therapies suggests that demand for IMV in elderly populations will increase in the future, both among patients that are likely to benefit and among those with terminal illness. We examined temporal trends in IMV use by older patients with and without dementia and projected future use.

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Projected Growth in Use of Invasive Mechanical Ventilation (IMV) by Patients 65 Years or Older With and Without Dementia

Shading indicates standard deviation. Data to the right of the vertical dashed line are projections.

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