Significant Clinical Factors Associated with Long-term Mortality in Critical Cancer Patients Requiring Prolonged Mechanical Ventilation
Abstract 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-intens...
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Nature Portfolio
2017
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oai:doaj.org-article:f16a39906c3040da937fc7b746c4cfd72021-12-02T11:53:02ZSignificant Clinical Factors Associated with Long-term Mortality in Critical Cancer Patients Requiring Prolonged Mechanical Ventilation10.1038/s41598-017-02418-42045-2322https://doaj.org/article/f16a39906c3040da937fc7b746c4cfd72017-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-02418-4https://doaj.org/toc/2045-2322Abstract 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.Li-Ta KengKuei-Pin ChungShu-Yung LinSheng-Kai LiangJui-Chen ChengI-Chun ChenYen-Fu ChenHou-Tai ChangChia-Lin HsuJih-Shuin JerngHao-Chien WangPing-Hung KuoHuey-Dong WuJin-Yuan ShihChong-Jen YuNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-8 (2017) |
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Medicine R Science Q Li-Ta Keng Kuei-Pin Chung Shu-Yung Lin Sheng-Kai Liang Jui-Chen Cheng I-Chun Chen Yen-Fu Chen Hou-Tai Chang Chia-Lin Hsu Jih-Shuin Jerng Hao-Chien Wang Ping-Hung Kuo Huey-Dong Wu Jin-Yuan Shih Chong-Jen Yu Significant Clinical Factors Associated with Long-term Mortality in Critical Cancer Patients Requiring Prolonged Mechanical Ventilation |
| description |
Abstract 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 |
article |
| author |
Li-Ta Keng Kuei-Pin Chung Shu-Yung Lin Sheng-Kai Liang Jui-Chen Cheng I-Chun Chen Yen-Fu Chen Hou-Tai Chang Chia-Lin Hsu Jih-Shuin Jerng Hao-Chien Wang Ping-Hung Kuo Huey-Dong Wu Jin-Yuan Shih Chong-Jen Yu |
| author_facet |
Li-Ta Keng Kuei-Pin Chung Shu-Yung Lin Sheng-Kai Liang Jui-Chen Cheng I-Chun Chen Yen-Fu Chen Hou-Tai Chang Chia-Lin Hsu Jih-Shuin Jerng Hao-Chien Wang Ping-Hung Kuo Huey-Dong Wu Jin-Yuan Shih Chong-Jen Yu |
| author_sort |
Li-Ta Keng |
| title |
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_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_sort |
significant clinical factors associated with long-term mortality in critical cancer patients requiring prolonged mechanical ventilation |
| publisher |
Nature Portfolio |
| publishDate |
2017 |
| url |
https://doaj.org/article/f16a39906c3040da937fc7b746c4cfd7 |
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