Prognostic factors for in-hospital mortality in elderly patients undergoing emergency intubation and invasive mechanical ventilation

BACKGROUND: Elderly patients requiring emergency intubation and invasive mechanical ventilation (IMV) in the emergency department (ED) face substantial mortality risk. However, prediction models utilizing only ED-obtainable variables for early prognostication remain limited. OBJECTIVE: To develop and internally validate a prognostic model using variables available at ED intubation to predict in-hospital mortality in elderly patients. METHODS: -statistic), calibration (calibration plot, Brier score), and clinical utility (decision curve analysis). RESULTS: -statistic 0.827). Sensitivity analyses confirmed model robustness. CONCLUSIONS: A parsimonious model incorporating age, GCS score, admission lactate, and vasopressor use accurately predicts in-hospital mortality in elderly patients undergoing emergency intubation and IMV, using only variables readily available at the time of ED presentation. This tool has the potential to facilitate early, evidence-informed shared decision-making.