Demographic and Clinical Risk Factors Contributing to Prolonged Mechanical Ventilation in ICU Patients at Tenwek Hospital

Abstract

Abstract Prolonged mechanical ventilation (PMV) remains a significant clinical challenge in intensive care units (ICUs). Approximately 30% of ventilated patients require PMV with attendant risk for higher morbidity, mortality, and healthcare expenditure. In spite of progress in critical care, little is known about the predictors and outcomes of PMV in low investigated the prevalence, demographic and clinical risk factors, and outcomes -resource settings. This study of prolonged mechanical ventilation in ICU patients at Tenwek Hospital. A retrospective cohort design was employed, reviewing medical records of adult ICU patients (≥18 years) who received invasive mechanical ventilation for more than seven consecutive days between January and December 2024. Patients were included if they had complete clinical documentation, ventilator parameters, and outcome data; those receiving only non-invasive ventilation or with missing critical records were excluded. Descriptive statistics and inferential analysis were used to analyse data. All associations were tested at p < 0.05. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were reported, with model stability ensured by maintaining a minimum of 10 events per predictor variable. Among 173 mechanically ventilated adults, 72.3% experienced prolonged mechanical ventilation. Multivariable logistic regression pinpointed acute respiratory distress syndrome (ARDS; adjusted OR = 5.25, 95% CI: 2.35-11.75) and chronic obstructive pulmonary disease (COPD; adjusted OR = 5.28, 95% CI: 2.38-11.73) as the strong predictors, followed by pneumonia (adjusted OR = 1.82, 95% CI: 0.80-4.14) and sepsis (adjusted OR = 1.56, 95% CI: 0.69-3.52). Daily sedation vacation reduced the odds of PMV by 81% (adjusted OR = 0.19, 95% CI: 0.08–0.46), while early mobility protocols diminished them by 37% (adjusted OR = 0.63, 95% CI: 0.28-1.42). These findings underscore the high burden of prolonged ventilation and recommend that simple, low-cost interventions such as structured sedation breaks and early mobilisation may significantly reduce the duration of ventilation and improve outcomes.