ArticleIntensive care medicine2020
Inter-country variability over time in the mortality of mechanically ventilated patients.
Article in Intensive care medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 33 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Fourth International Study of Mechanical Ventilation From VENTILA GROUP
Assessment of Clinical Practice of Mechanical Ventilation After COVID-19 Pan-demic Among 57 Countries: A Systematic Analysis for the Global BurdEn of Me-chanIcal VeNtilatIon (GEMINI Study) 2022, From VENTILAGROUP.
Monitoring of Breathing Effort Through Pressure Time Product Measurement Using Airway Occlusion Pressure
Who cites it
33 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Joint statement on evidence-based practices in mechanical ventilation: suggestions from two Brazilian medical societies.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2025Guideline
- Effect of different levels of PEEP on mortality in ICU patients without acute respiratory distress syndrome: systematic review and meta-analysis with trial sequential analysis.Journal of critical care · 2021Pooled it
- Optimal Positive End Expiratory Pressure Levels in Ventilated Patients Without Acute Respiratory Distress Syndrome: A Bayesian Network Meta-Analysis and Systematic Review of Randomized Controlled Trials.Frontiers in medicine · 2021Pooled it
- Cost-Effectiveness of In-Bed Cycling and Routine Physiotherapy for Patients Receiving Mechanical Ventilation.JAMA network open · 2025Trial
- Trial
- Targeting the diaphragm during weaning from mechanical ventilation.Journal of thoracic disease · 2026Article
- Ventilator Settings and Monitoring Variables Associated with Extubation Failure in Critically Ill Patients: A Retrospective Cohort Study.Critical care science · 2026Observational
- Observational
- Assessing fluid responsiveness by using functional hemodynamic tests in critically ill patients: a narrative review and a profile-based clinical guide.Journal of clinical monitoring and computing · 2025Review
- An Updated Review on the Use of Noninvasive Respiratory Supports in the Management of Severe Asthma Exacerbations.Medicina (Kaunas, Lithuania) · 2025Review
- Joint statement on evidence-based practices in mechanical ventilation: suggestions from two Brazilian medical societies.Critical care science · 2025Article
- A worldwide assessment of the mechanical ventilation in patients with acute exacerbations of chronic obstructive pulmonary disease. Analysis of the VENTILAGROUP over time. A retrospective, multicenter study.Respiratory research · 2024Observational
- In-hospital mortality, comorbidities, and costs of one million mechanically ventilated patients in Germany: a nationwide observational study before, during, and after the COVID-19 pandemic.The Lancet regional health. Europe · 2024Article
- Bridging the Gap Between Detection, Understanding, and Future Innovation in Patient-Ventilator Asynchronies.Respiratory care · 2024Article
- Severe asthma exacerbation: Changes in patient characteristics, management, and outcomes from 1997 to 2016 in 40 ICUs in the greater Paris area.Journal of intensive medicine · 2024Article
- Mechanical ventilation in patients with idiopathic pulmonary fibrosis in Korea: a nationwide cohort study.The Korean journal of internal medicine · 2024Observational
- Maintaining moderate versus lower PEEP after cardiac surgery: a propensity-scored matched analysis.BMC anesthesiology · 2024Article
- Association between mechanical power and intensive care unit mortality in Korean patients under pressure-controlled ventilation.Acute and critical care · 2024Article
- Association Between the Site of Infection and Mortality Analysis in Critically Ill Surgical Patients.Cureus · 2023Article
- The effect of age on clinical outcomes in critically ill brain-injured patients.Acta neurologica Belgica · 2023Observational
Corrections and comments
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Authors and funding
28 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeVariations in clinical characteristics and management and in the mortality of mechanically ventilated patients have not been sufficiently evaluated. We hypothesized that mortality shows a variability associated with country after adjustment for clinical characteristics and management.
methodsAnalysis of four studies carried out at 6-year intervals over an 18-year period. The studies included 26,024 patients (5183 in 1998, 4968 in 2004, 8108 in 2010, and 7765 in 2016) admitted to 1253 units from 38 countries. The primary outcome was 28-day mortality. We performed analyses using multilevel logistic modeling with mixed-random effects, including country as a random variable. To evaluate the effect of management strategies on mortality, a mediation analysis was performed.
resultsAdjusted 28-day mortality decreased significantly over time (first study as reference): 2004: odds ratio 0.82 (95% confidence interval [CI] 0.72-0.93); 2010: 0.63 (95% CI 0.53-0.75); 2016: 0.49 (95% CI 0.39-0.61). A protective ventilatory strategy and the use of continuous sedation mediated a moderate fraction of the effect of time on mortality in patients with moderate hypoxemia and without hypoxemia, respectively. Logistic multilevel modeling showed a significant effect of country on mortality: median odds ratio (MOR) in 1998: 2.02 (95% CI 1.57-2.48); in 2004: 1.76 (95% CI 1.47-2.06); in 2010: 1.55 (95% CI 1.37-1.74), and in 2016: 1.39 (95% CI 1.25-1.54).
conclusionsThese findings suggest that country could contribute, independently of confounder variables, to outcome. The magnitude of the effect of country decreased over time. Clinical trials registered with http://www.clinicaltrials.gov (NCT02731898).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.