Objective: To determine factors predictive to survival for patients transferred to respiratory care ward after prolonged mechanical ventilation. Methods: We reviewed medical records in a hospital in southern Taiwan between January 1, 2003 and December 31, 2006 to collect clinical data while transferred to respiratory care ward. The National death certification database of Taiwan was linked to ascertain the date of death. Kaplan-Meier estimation was performed for survival analysis; Cox proportional hazards model was constructed based on various patient characteristics, including age, gender, education, co-morbidity with diabetes, stroke, chronic obstructive pulmonary disease, end stage renal disease and blood platelet. A strategy of backward selection was taken. Results: Two hundred and eighty-seven patients who required chronic mechanical ventilation in intensive care unit were included in this study. Their median age was 77 years, 56% were male. Survival rate of 90 days and 180 days following transfer to respiratory care ward were 70 and 50%, respectively. After taking age, gender, and various co-morbidity into consideration, the adjusted hazard ratios for end stage renal disease and abnormal blood platelet count were 1.56(95% confidence interval(CI), 1.12-2.15) and 1.40 (95%CI, 1.04-1.90), respectively. Conclusion: Overall survival of patients with prolonged mechanical ventilation was poor, especially for patients with end stage renal disease or/and abnormal blood platelet count.