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Significant Clinical Factors Associated with Long-term Mortality in Critical Cancer Patients Requiring Prolonged Mechanical Ventilation
Studies about prognostic assessment in cancer patients requiring prolonged mechanical ventilation (PMV) for post-intensive care are scarce. We retrospectively enrolled 112 cancer patients requiring PMV support who were admitted to the respiratory care center (RCC), a specialized post-intensive care...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5438375/ https://www.ncbi.nlm.nih.gov/pubmed/28526862 http://dx.doi.org/10.1038/s41598-017-02418-4 |
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author | Keng, Li-Ta Chung, Kuei-Pin Lin, Shu-Yung Liang, Sheng-Kai Cheng, Jui-Chen Chen, I-Chun Chen, Yen-Fu Chang, Hou-Tai Hsu, Chia-Lin Jerng, Jih-Shuin Wang, Hao-Chien Kuo, Ping-Hung Wu, Huey-Dong Shih, Jin-Yuan Yu, Chong-Jen |
author_facet | Keng, Li-Ta Chung, Kuei-Pin Lin, Shu-Yung Liang, Sheng-Kai Cheng, Jui-Chen Chen, I-Chun Chen, Yen-Fu Chang, Hou-Tai Hsu, Chia-Lin Jerng, Jih-Shuin Wang, Hao-Chien Kuo, Ping-Hung Wu, Huey-Dong Shih, Jin-Yuan Yu, Chong-Jen |
author_sort | Keng, Li-Ta |
collection | PubMed |
description | Studies about prognostic assessment in cancer patients requiring prolonged mechanical ventilation (PMV) for post-intensive care are scarce. We retrospectively enrolled 112 cancer patients requiring PMV support who were admitted to the respiratory care center (RCC), a specialized post-intensive care weaning facility, from November 2009 through September 2013. The weaning success rate was 44.6%, and mortality rates at hospital discharge and after 1 year were 43.8% and 76.9%, respectively. Multivariate logistic regression showed that weaning failure, in addition to underlying cancer status, was significantly associated with an increased 1-year mortality (odds ratio, 6.269; 95% confidence interval, 1.800–21.834; P = 0.004). Patients who had controlled non-hematologic cancers and successful weaning had the longest median survival, while those with other cancers who failed weaning had the worst. Patients with low maximal inspiratory pressure, anemia, and poor oxygenation at RCC admission had an increased risk of weaning failure. In conclusion, cancer status and weaning outcome were the most important determinants associated with long-term mortality in cancer patients requiring PMV. We suggest palliative care for those patients with clinical features associated with worse outcomes. It is unknown whether survival in this specific patient population could be improved by modifying the risk of weaning failure. |
format | Online Article Text |
id | pubmed-5438375 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-54383752017-05-22 Significant Clinical Factors Associated with Long-term Mortality in Critical Cancer Patients Requiring Prolonged Mechanical Ventilation Keng, Li-Ta Chung, Kuei-Pin Lin, Shu-Yung Liang, Sheng-Kai Cheng, Jui-Chen Chen, I-Chun Chen, Yen-Fu Chang, Hou-Tai Hsu, Chia-Lin Jerng, Jih-Shuin Wang, Hao-Chien Kuo, Ping-Hung Wu, Huey-Dong Shih, Jin-Yuan Yu, Chong-Jen Sci Rep Article Studies about prognostic assessment in cancer patients requiring prolonged mechanical ventilation (PMV) for post-intensive care are scarce. We retrospectively enrolled 112 cancer patients requiring PMV support who were admitted to the respiratory care center (RCC), a specialized post-intensive care weaning facility, from November 2009 through September 2013. The weaning success rate was 44.6%, and mortality rates at hospital discharge and after 1 year were 43.8% and 76.9%, respectively. Multivariate logistic regression showed that weaning failure, in addition to underlying cancer status, was significantly associated with an increased 1-year mortality (odds ratio, 6.269; 95% confidence interval, 1.800–21.834; P = 0.004). Patients who had controlled non-hematologic cancers and successful weaning had the longest median survival, while those with other cancers who failed weaning had the worst. Patients with low maximal inspiratory pressure, anemia, and poor oxygenation at RCC admission had an increased risk of weaning failure. In conclusion, cancer status and weaning outcome were the most important determinants associated with long-term mortality in cancer patients requiring PMV. We suggest palliative care for those patients with clinical features associated with worse outcomes. It is unknown whether survival in this specific patient population could be improved by modifying the risk of weaning failure. Nature Publishing Group UK 2017-05-19 /pmc/articles/PMC5438375/ /pubmed/28526862 http://dx.doi.org/10.1038/s41598-017-02418-4 Text en © The Author(s) 2017 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Keng, Li-Ta Chung, Kuei-Pin Lin, Shu-Yung Liang, Sheng-Kai Cheng, Jui-Chen Chen, I-Chun Chen, Yen-Fu Chang, Hou-Tai Hsu, Chia-Lin Jerng, Jih-Shuin Wang, Hao-Chien Kuo, Ping-Hung Wu, Huey-Dong Shih, Jin-Yuan Yu, Chong-Jen Significant Clinical Factors Associated with Long-term Mortality in Critical Cancer Patients Requiring Prolonged Mechanical Ventilation |
title | Significant Clinical Factors Associated with Long-term Mortality in Critical Cancer Patients Requiring Prolonged Mechanical Ventilation |
title_full | Significant Clinical Factors Associated with Long-term Mortality in Critical Cancer Patients Requiring Prolonged Mechanical Ventilation |
title_fullStr | Significant Clinical Factors Associated with Long-term Mortality in Critical Cancer Patients Requiring Prolonged Mechanical Ventilation |
title_full_unstemmed | Significant Clinical Factors Associated with Long-term Mortality in Critical Cancer Patients Requiring Prolonged Mechanical Ventilation |
title_short | Significant Clinical Factors Associated with Long-term Mortality in Critical Cancer Patients Requiring Prolonged Mechanical Ventilation |
title_sort | significant clinical factors associated with long-term mortality in critical cancer patients requiring prolonged mechanical ventilation |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5438375/ https://www.ncbi.nlm.nih.gov/pubmed/28526862 http://dx.doi.org/10.1038/s41598-017-02418-4 |
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