Can we predict patients that will not benefit from invasive mechanical ventilation? A novel scoring system in intensive care: the IMV Mortality Prediction Score (IMPRES

Abstract

Background/aim: The present study aimed to define the clinical and laboratory criteria for predicting patients that will not benefit frominvasive mechanical ventilation (IMV) treatment and determine the prediction of mortality and prognosis of these critical ill patients.Materials and methods: The study was designed as an observational, multicenter, prospective, and cross-sectional clinical study. It wasconducted by 75 researchers at 41 centers in intensive care units (ICUs) located in various geographical areas of Turkey. It included a totalof 1463 ICU patients who were receiving invasive mechanical ventilation (IMV) treatment. A total of 158 parameters were examinedvia logistic regression analysis to identify independent risk factors for mortality; using these data, the IMV Mortality Prediction Score(IMPRES) scoring system was developed.Results: The following cut-off scores were used to indicate mortality risk: 8, very highrisk. There was a 26.8% mortality rate among the 254 patients who had a total IMPRES score of lower than 2. The mortality rate was93.3% for patients with total IMPRES scores of greater than 8 (P < 0.001).Conclusion: The present study included a large number of patients from various geographical areas of the country who were admittedto various types of ICUs, had diverse diagnoses and comorbidities, were intubated with various indications in either urgent or electivesettings, and were followed by physicians from various specialties. Therefore, our data are more general and can be applied to a broaderpopulation. This study devised a new scoring system for decision-making for critically ill patients as to whether they need to be intubatedor not and presents a rapid and accurate prediction of mortality and prognosis prior to ICU admission using simple clinical data.