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Analyzing 50,481 victims of prolonged mechanical ventilation in Taiwan 1997-2007, Hung et al report outcomes were frankly terrible, with median survival of about 4 months. Those with a primary indication of neurologic damage fared significantly better. Those with a PMV indication of COPD, younger than 85, had 6-18 months median survival. Authors take the additional steps of incorporating actuarial life expectancy data for comparison and suggest a QALY cost analysis for prolonged mechanical ventilation as an intervention in the elderly. Critical Care 2011;15:R107. FULL FREE TEXT