• F D Martos-Benítez, A Gutiérrez-Noyola, M Badal, and N A Dietrich.
• Department of Intensive Care, Institute of Oncology and Radiobiology, 29 Street, Vedado, Havana, Cuba. Electronic address: fdmartos@infomed.sld.cu.
• Med Intensiva. 2017 Sep 28.

ObjectivesTo 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.DesignA retrospective cohort study was carried out.SettingA 12-bed oncological intensive care unit (ICU) from January 2014 to December 2015.PatientsA 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.InterventionsNone.VariablesClinical 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.ResultsThe SARF-MV rate was 15.8%. The multivariate analysis identified brain tumour (OR 14.54; 95%CI 3.86-54.77; p<0.0001), 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 (p<0.0001), a lower ICU survival rate (p<0.0001) and a lower hospital survival rate (p<0.0001).ConclusionsA 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.Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

11 keywords...

hide…