Analysis of Medical Resource Utilization and Outcome of Inhaled Nitric Oxide in Patients Undergoing Mechanical Ventilation

Abstract

Background: Inhaled nitric oxide (iNO) is a potent selective pulmonary vasodilator, which is used in critically ill patients to improve oxygenation. It avoids systemic hypotension and ventilator-induced lung injury in patients using ventilators. This study explored the medical resource utilization and outcome, and predicted risk factors for mortality in patients using ventilators with iNO. Methods: The database was from the National Health Insurance hospital claims data in Taiwan from 2004 to 2009. The patients using ventilators with iNO were collected and stratified by age to 20–44 years, 45–64 years, 65–74 years, and ≥ 75 years. Results: Seven hundred and thirty ventilator patients with iNO were enrolled (63.15% male, mean age 60 years). Mechanical ventilation (MV) weaning rate was 18.25%, intensive care unit (ICU) readmission rate was 5.75%, and ICU mortality rate was 74.52%. ICU mortality rate was lower, case-mix index, MV weaning rate, and hospital costs were higher for patients aged 20–44 years and 45–64 years than in those aged 65–74 years and ≥ 75 years (p < 0.05). Sex, case-mix index, Charlson comorbidity index, whether MV weaning (p < 0.001), different age group, and implementation of tracheostomy (p < 0.05) were all significant risk factors in predicting mortality of patients using ventilators with iNO. Conclusion: This study showed that the outcome differed with age in patients using ventilators with iNO.

Keywords

• case mix index
• comorbidity
• nitric oxide
• utilization
• ventilators