PURPOSE: To describe hospital survival for cancer patients who require mechanical ventilation. MATERIALS AND METHODS: A prospective, multicenter observational study was performed at five academic tertiary care hospitals. Demographic and clinical variables were obtained on consecutive cancer patients at initiation of mechanical ventilation, and information on vital status at hospital discharge was acquired. RESULTS: Our analysis was based on 782 adult cancer patients who met predetermined inclusion criteria. The overall observed hospital mortality was 76%, with no statistically significant differences among the five study centers. Seven variables (intubation after 24 hours, leukemia, progression or recurrence of cancer, allogeneic bone marrow transplantation, cardiac arrhythmias, presence of disseminated intravascular coagulation, and need for vasopressor therapy) were associated with an increased risk of death, whereas prior surgery with curative intent was protective. The predictive model based on these variables had an area under the receiver operating characteristic curve of 0.736, with Hosmer-Lemeshow goodness-of-fit statistics of 7.19; P = .52. CONCLUSION: This model can be used to estimate the probability of hospital survival for classes of adult cancer patients who require mechanical ventilation and can help to guide physicians, patients, and families in deciding goals and direction of treatment. Prospective independent validation in different medical settings is warranted.
PURPOSE: To describe hospital survival for cancerpatients who require mechanical ventilation. MATERIALS AND METHODS: A prospective, multicenter observational study was performed at five academic tertiary care hospitals. Demographic and clinical variables were obtained on consecutive cancerpatients at initiation of mechanical ventilation, and information on vital status at hospital discharge was acquired. RESULTS: Our analysis was based on 782 adult cancerpatients who met predetermined inclusion criteria. The overall observed hospital mortality was 76%, with no statistically significant differences among the five study centers. Seven variables (intubation after 24 hours, leukemia, progression or recurrence of cancer, allogeneic bone marrow transplantation, cardiac arrhythmias, presence of disseminated intravascular coagulation, and need for vasopressor therapy) were associated with an increased risk of death, whereas prior surgery with curative intent was protective. The predictive model based on these variables had an area under the receiver operating characteristic curve of 0.736, with Hosmer-Lemeshow goodness-of-fit statistics of 7.19; P = .52. CONCLUSION: This model can be used to estimate the probability of hospital survival for classes of adult cancerpatients who require mechanical ventilation and can help to guide physicians, patients, and families in deciding goals and direction of treatment. Prospective independent validation in different medical settings is warranted.
Authors: Stephen M Pastores; Debra A Goldman; David J Shaz; Natalie Kostelecky; Ryan J Daley; Tim J Peterson; Kay See Tan; Neil A Halpern Journal: Cancer Date: 2018-05-04 Impact factor: 6.860
Authors: Peter Schellongowski; Michael Benesch; Thomas Lang; Friederike Traunmüller; Christian Zauner; Klaus Laczika; Gottfried J Locker; Michael Frass; Thomas Staudinger Journal: Intensive Care Med Date: 2003-11-04 Impact factor: 17.440
Authors: So Young Park; So Yeon Lim; Sang-Won Um; Won-Jung Koh; Man Pyo Chung; Hojoong Kim; O Jung Kwon; Hye Kyeong Park; Seok Jin Kim; Young Hyuck Im; Myung-Ju Ahn; Gee Young Suh Journal: Support Care Cancer Date: 2013-01-12 Impact factor: 3.603
Authors: Peter A Hampshire; Catherine A Welch; Lawrence A McCrossan; Katharine Francis; David A Harrison Journal: Crit Care Date: 2009-08-25 Impact factor: 9.097