End of life decisions in immunocompromised patients with acute respiratory failure
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064165%3A_____%2F22%3A10451023" target="_blank" >RIV/00064165:_____/22:10451023 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11110/22:10451023
Result on the web
<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=YurRptgR0I" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=YurRptgR0I</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1016/j.jcrc.2022.154152" target="_blank" >10.1016/j.jcrc.2022.154152</a>
Alternative languages
Result language
angličtina
Original language name
End of life decisions in immunocompromised patients with acute respiratory failure
Original language description
Purpose: To identify patient, disease and organizational factors associated with decisions to forgo life-sustaining therapies (DFLSTs) in critically ill immunocompromised patients admitted to the intensive care unit (ICU) for acute respiratory failure.Material and methods: We performed a secondary analysis of the international EFRAIM prospective study, which enrolled 1611 immunocompromised patients with acute respiratory failure admitted to 68 ICUs in 16 countries between October 2015 and June 2016. Multivariate logistic analysis was performed to identify independent pre-dictors of DFLSTs.Results: The main causes of immunosuppression were hematological malignancies (50%) and solid tumor (38%). Patients had a median age of 63 yo (54-71). A pulmonologist was involved in the patient management in 38% of cases. DFLSTs had been implemented in 28% of the patients. The following variables were independently associ-ated with DFLSTs: 1) patient-related: older age (OR 1.02 per one year increase, 95% confidence interval(CI) 1.01-1.03,P < 0.001), poor performance status (OR 2.79, 95% CI 1.98-3.93, P < 0.001); 2) disease-related: shock (OR 2.00, 95% CI 1.45-2.75, P < 0.001), liver failure (OR 1.59, 95% CI 1.14-2.21, P = 0.006), invasive me-chanical ventilation (OR 1.79, 95% CI 1.31-2.46, P < 0.001); 3) organizational: having a pulmonologist involved in patient management (OR 1.85, 95% CI 1.36-2.52, P < 0.001), and the presence of a critical care outreach ser-vices (OR 1.63, 95% CI 1.11-2.38, P = 0.012).Conclusions: A DFLST is made in one in four immunocompromised patient admitted to the ICU for acute respira-tory failure. Involving a pulmonologist in patient's management is associated with less non beneficial care.(c) 2022 Elsevier Inc. All rights reserved.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30221 - Critical care medicine and Emergency medicine
Result continuities
Project
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Continuities
V - Vyzkumna aktivita podporovana z jinych verejnych zdroju
Others
Publication year
2022
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Journal of Critical Care
ISSN
0883-9441
e-ISSN
1557-8615
Volume of the periodical
72
Issue of the periodical within the volume
December
Country of publishing house
US - UNITED STATES
Number of pages
7
Pages from-to
154152
UT code for WoS article
000883256700010
EID of the result in the Scopus database
2-s2.0-85138220271