• Michael Ma, Tara Feeley, Peter McCauley, James Duncan, Fardeen Maudarbaccus, Orla Murphy, Lorcan O'Carroll, Darren McMahon, Ruth Fenton, Aoife Feeley, Dylan Finnerty, Enda O'Connor, Alejandro Rodriguez, and Ignacio Martin-Loeches.
• Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St. James's Hospital, Dublin, Ireland.
• J Crit Care. 2021 Jun 1; 63: 26-31.

IntroductionThe number of hospitalized immunosuppressed adults is a growing and often develop severe complications that require admission to an Intensive Care Unit (ICU). The main cause of admission is acute respiratory failure (ARF). The goal of the study was to determine if ARF represents an independent risk factor for hospital mortality and in particular, we sought to ascertain if any risk factors were independently and identifiably associated with a bad outcome.MethodsWe perform a retrospective study of a prospectively collected data from patients admitted to an ICU. Adult patients with known immunosuppressive condition admitted to ICU were included.ResultsA total of 248 patients were included. Of 248 patients, 117 (47.2%) had a diagnosis of ARF at the time of ICU admission. Patients with ARF had a significantly higher in-hospital mortality (53.4% vs. 28.2% p = 0.001). Factors independently associated with hospital mortality were diagnosis of ARF at ICU admission, the presence of septic shock, use of continuous renal replacement therapy and failure of high-flow nasal canula(HFNC)/non-invasive (NIV) respiratory therapies.ConclusionWe identified ARF on admission and failure of HFNC/NIV to be independently associated with increased hospital mortality in immunosuppressed patients.Copyright © 2021. Published by Elsevier Inc.

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