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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 &lt; 0.001), poor performance status (OR 2.79, 95% CI 1.98-3.93, P &lt; 0.001); 2) disease-related: shock (OR 2.00, 95% CI 1.45-2.75, P &lt; 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 &lt; 0.001); 3) organizational: having a pulmonologist involved in patient management (OR 1.85, 95% CI 1.36-2.52, P &lt; 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&apos;s management is associated with less non beneficial care.(c) 2022 Elsevier Inc. All rights reserved.

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30221 - Critical care medicine and Emergency medicine

Result continuities

  • Project

  • 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