End of life decisions in immunocompromised patients with acute respiratory failure

Kód výsledku v 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>

Nalezeny alternativní kódy

RIV/00216208:11110/22:10451023

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

End of life decisions in immunocompromised patients with acute respiratory failure

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

End of life decisions in immunocompromised patients with acute respiratory failure

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30221 - Critical care medicine and Emergency medicine

Projekt

—

Návaznosti

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Rok uplatnění

2022

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of Critical Care

ISSN

0883-9441

e-ISSN

1557-8615

Svazek periodika

72

Číslo periodika v rámci svazku

December

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

7

Strana od-do

154152

Kód UT WoS článku

000883256700010

EID výsledku v databázi Scopus

2-s2.0-85138220271