Acute respiratory distress syndrome in patients with cancer: the YELENNA prospective multinational observational cohort study

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00669806%3A_____%2F25%3A10503166" target="_blank" >RIV/00669806:_____/25:10503166 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11110/25:10503166 RIV/00216208:11140/25:10503166 RIV/00064165:_____/25:10503166

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=c1rJkVQ0we" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=c1rJkVQ0we</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s00134-025-08113-7" target="_blank" >10.1007/s00134-025-08113-7</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Acute respiratory distress syndrome in patients with cancer: the YELENNA prospective multinational observational cohort study

Popis výsledku v původním jazyce

PURPOSE: Acute respiratory failure is the leading reason for intensive care unit (ICU) admission among critically ill patients with cancer. We aimed to describe the clinical characteristics, risk factors, and outcomes of patients with cancer and acute respiratory distress syndrome (ARDS) and to evaluate associations of venovenous extracorporeal membrane oxygenation (ECMO) with outcomes in the subgroup with severe ARDS. METHODS: We conducted a multinational, prospective, observational cohort study of patients with cancer and ARDS in 13 countries in Europe and North America. The primary endpoint was 90-day mortality. RESULTS: Among 715 included patients, 73.4% had hematologic malignancies and 26.6% solid tumors; 31.2% had undergone hematopoietic stem-cell transplantation (168 allogeneic). ICU, hospital, and 90-day mortality rates were 55.3%, 70.9%, and 73.2%, respectively. By multivariate analysis, independent predictors of higher 90-day mortality were older age, peripheral vascular disease, severe ARDS at inclusion, acute kidney injury, and ICU admission as a time-limited trial (vs. full code). Conversely, lymphoma was associated with lower 90-day mortality. Among the 322 patients (45.7%) with severe ARDS at inclusion, 90-day mortality was 82.2%; with no difference between patients who received ECMO (n = 58, 18%) and those who did not (82.6% vs. 80.7%, P = 0.89). This finding remained unchanged in a double-adjusted overlap- and propensity-weighted Cox mixed-effects model (adjusted hazard ratio, 1.12; 95% confidence interval 0.65-1.94; P = 0.69). CONCLUSION: Patients with cancer and ARDS, particularly severe forms, experience high 90-day mortality, irrespective of ECMO use. These findings suggest a need for nuanced ICU goals-of-care discussions and raise concerns about the generalizability of ECMO guidelines to this population.

Název v anglickém jazyce

Acute respiratory distress syndrome in patients with cancer: the YELENNA prospective multinational observational cohort study

Popis výsledku anglicky

PURPOSE: Acute respiratory failure is the leading reason for intensive care unit (ICU) admission among critically ill patients with cancer. We aimed to describe the clinical characteristics, risk factors, and outcomes of patients with cancer and acute respiratory distress syndrome (ARDS) and to evaluate associations of venovenous extracorporeal membrane oxygenation (ECMO) with outcomes in the subgroup with severe ARDS. METHODS: We conducted a multinational, prospective, observational cohort study of patients with cancer and ARDS in 13 countries in Europe and North America. The primary endpoint was 90-day mortality. RESULTS: Among 715 included patients, 73.4% had hematologic malignancies and 26.6% solid tumors; 31.2% had undergone hematopoietic stem-cell transplantation (168 allogeneic). ICU, hospital, and 90-day mortality rates were 55.3%, 70.9%, and 73.2%, respectively. By multivariate analysis, independent predictors of higher 90-day mortality were older age, peripheral vascular disease, severe ARDS at inclusion, acute kidney injury, and ICU admission as a time-limited trial (vs. full code). Conversely, lymphoma was associated with lower 90-day mortality. Among the 322 patients (45.7%) with severe ARDS at inclusion, 90-day mortality was 82.2%; with no difference between patients who received ECMO (n = 58, 18%) and those who did not (82.6% vs. 80.7%, P = 0.89). This finding remained unchanged in a double-adjusted overlap- and propensity-weighted Cox mixed-effects model (adjusted hazard ratio, 1.12; 95% confidence interval 0.65-1.94; P = 0.69). CONCLUSION: Patients with cancer and ARDS, particularly severe forms, experience high 90-day mortality, irrespective of ECMO use. These findings suggest a need for nuanced ICU goals-of-care discussions and raise concerns about the generalizability of ECMO guidelines to this population.

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

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2025

Kód důvěrnosti údajů

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

Název periodika

Intensive Care Medicine

ISSN

0342-4642

e-ISSN

1432-1238

Svazek periodika

51

Číslo periodika v rámci svazku

10

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

11

Strana od-do

1809-1819

Kód UT WoS článku

001578709800001

EID výsledku v databázi Scopus

2-s2.0-105017980254