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To the Editor: In a large international study, Dr Esteban and colleagues¹ found a 28-day survival rate of 69.3% among adult patients requiring mechanical ventilation. Survival in the subset of patients with chronic obstructive pulmonary disease (COPD) was 72%.

These outcomes are quite similar to the 75% survival rate that my colleagues and Ireported in 1975,² over a 10-year period in a single intensive care unit. We found the death rate among patients with COPD to be 79.8%. Of course, our study did not identify age, sex, or APACHE III score (because it had not yet been defined). But the outcome in 1877 consecutive patients ventilated for more than 12 hours, like the entry criteria of Esteban et al,¹ compare favorably with ours. It is likely that the study of Esteban et al¹ may have enrolled more severe patients, hence comparisons would be difficult.

Thomas L. Petty, MD
Department of . . . [Full Text of this Article]