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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| Format: | Article |
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Nature Portfolio
2017-05-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-017-02418-4 |
| _version_ | 1818420180369276928 |
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| 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 |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-14T12:50:22Z |
| format | Article |
| id | doaj.art-f16a39906c3040da937fc7b746c4cfd7 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-14T12:50:22Z |
| publishDate | 2017-05-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj.art-f16a39906c3040da937fc7b746c4cfd72022-12-21T23:00:42ZengNature PortfolioScientific Reports2045-23222017-05-01711810.1038/s41598-017-02418-4Significant Clinical Factors Associated with Long-term Mortality in Critical Cancer Patients Requiring Prolonged Mechanical VentilationLi-Ta Keng0Kuei-Pin Chung1Shu-Yung Lin2Sheng-Kai Liang3Jui-Chen Cheng4I-Chun Chen5Yen-Fu Chen6Hou-Tai Chang7Chia-Lin Hsu8Jih-Shuin Jerng9Hao-Chien Wang10Ping-Hung Kuo11Huey-Dong Wu12Jin-Yuan Shih13Chong-Jen Yu14Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu BranchDepartment of Laboratory Medicine, National Taiwan University HospitalDepartment of Internal Medicine, National Taiwan University HospitalDepartment of Internal Medicine, National Taiwan University Hospital Hsin-Chu BranchDepartment of Integrated Diagnostics and Therapeutics, National Taiwan University HospitalDepartment of Oncology, National Taiwan University HospitalDepartment of Internal Medicine, National Taiwan University Hospital Yun-Lin BranchDepartment of Internal Medicine and Department of Critical Care Medicine, Far Eastern Memorial HospitalDepartment of Internal Medicine, National Taiwan University HospitalDepartment of Internal Medicine, National Taiwan University HospitalDepartment of Internal Medicine, National Taiwan University HospitalDepartment of Internal Medicine, National Taiwan University HospitalDepartment of Internal Medicine, National Taiwan University HospitalDepartment of Internal Medicine, National Taiwan University HospitalDepartment of Internal Medicine, National Taiwan University HospitalAbstract 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.https://doi.org/10.1038/s41598-017-02418-4 |
| spellingShingle | 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 Scientific Reports |
| 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 |
| url | https://doi.org/10.1038/s41598-017-02418-4 |
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