Risk factors and outcomes of severe acute respiratory failure requiring invasive mechanical ventilation in cancer patients: A retrospective cohort study
| Autor: | M. Badal, Anarelys Gutiérrez-Noyola, N.A. Dietrich, Frank Daniel Martos-Benítez |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Multivariate analysis medicine.medical_treatment Critical Care and Intensive Care Medicine Severity of Illness Index law.invention Cohort Studies 03 medical and health sciences 0302 clinical medicine law Risk Factors Neoplasms Severity of illness medicine Humans Intensive care medicine Aged Retrospective Studies Mechanical ventilation Respiratory Distress Syndrome business.industry Medical record Cancer 030208 emergency & critical care medicine Retrospective cohort study Middle Aged medicine.disease Intensive care unit Respiration Artificial Treatment Outcome 030220 oncology & carcinogenesis Female business Cohort study |
| Zdroj: | Medicina Intensiva (English Edition). 42:354-362 |
| ISSN: | 2173-5727 |
| Popis: | To determine the risk factors for severe acute respiratory failure requiring invasive mechanical ventilation (SARF-MV) and its effect upon clinical outcomes in critically ill cancer patients.A retrospective cohort study was carried out.A 12-bed oncological intensive care unit (ICU) from January 2014 to December 2015.A total of 878 consecutive cancer patients were included. Patients with an ICU stay of ≤1 day were excluded. The final sample size was 691 patients.None.Clinical variables at ICU admission were extracted from the medical records. The primary outcome was SARF-MV. We also measured ICU and hospital mortality, as well as length of stay.The SARF-MV rate was 15.8%. The multivariate analysis identified brain tumour (OR 14.54; 95%CI 3.86-54.77; p0.0001), stage IV cancer (OR 3.47; 95%CI 1.26-9.54; p=0.016), sepsis upon admission (OR 2.28; 95%CI 1.14-4.56; p=0.020) and an APACHE II score≥20 points (OR 5.38; 95%CI 1.92-15.05; p=0.001) as being independently associated to SARF-MV. Compared with the patients without SARF-MV, those with SARF-MV had a prolonged length of ICU stay (p0.0001), a lower ICU survival rate (p0.0001) and a lower hospital survival rate (p0.0001).A number of clinical factors are related to SARF-MV. In this regard, SARF-MV is a powerful factor independently correlated to poor outcomes. Future studies should investigate means for preventing SARF-MV in critically ill cancer patients, which may have an impact upon outcomes. |
| Databáze: | OpenAIRE |
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