Results:
Twenty Iowa hospitals were evaluated. Data collected on 224 				patients demonstrated a mean age of 70 years and a mean ICU admission Acute 				Physiology and Chronic Health Evaluation (APACHE) II score of 22, with an 				associated 36% mortality. Mean length of ICU stay was 10 days, with 7.7 				ventilated days. Significant differences were found in both institutional and 				patient variables between rural referral hospitals and rural hospitals with 				more limited resources. A subgroup of patients with diagnoses associated with 				complex ventilation had higher mortality rates than patients without these 				conditions. Patients who developed nosocomial events had longer mean ventilator 				and ICU days than patients without nosocomial events. This study also found ICU 				practices that frequently fell outside the guidelines recommended by a task 				force describing minimum standards of care for critically ill patients with 				acute respiratory failure on mechanical ventilation.