Supportive Care in Cancer

, Volume 21, Issue 6, pp 1647–1653

Outcome and predictors of mortality in patients requiring invasive mechanical ventilation due to acute respiratory failure while undergoing ambulatory chemotherapy for solid cancers

Authors

  • So Young Park
    • Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chuncheon Sacred Heart HospitalHallym University Medical Center
  • So Yeon Lim
    • Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical CenterSunkyunkwan University School of Medicine
  • Sang-Won Um
    • Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical CenterSunkyunkwan University School of Medicine
  • Won-Jung Koh
    • Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical CenterSunkyunkwan University School of Medicine
  • Man Pyo Chung
    • Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical CenterSunkyunkwan University School of Medicine
  • Hojoong Kim
    • Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical CenterSunkyunkwan University School of Medicine
  • O Jung Kwon
    • Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical CenterSunkyunkwan University School of Medicine
  • Hye Kyeong Park
    • Division of Pulmonary and Critical Care Medicine, Department of Medicine, Ilsan Paik HospitalInje University College of Hospital
  • Seok Jin Kim
    • Department of Hematology & Oncology, Department of Medicine, Samsung Medical CenterSungkyunkwan University School of Medicine
  • Young Hyuck Im
    • Department of Hematology & Oncology, Department of Medicine, Samsung Medical CenterSungkyunkwan University School of Medicine
  • Myung-Ju Ahn
    • Department of Hematology & Oncology, Department of Medicine, Samsung Medical CenterSungkyunkwan University School of Medicine
    • Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical CenterSunkyunkwan University School of Medicine
Original Article

DOI: 10.1007/s00520-012-1709-z

Cite this article as:
Park, S.Y., Lim, S.Y., Um, S. et al. Support Care Cancer (2013) 21: 1647. doi:10.1007/s00520-012-1709-z

Abstract

Purpose

Acute respiratory failure that requires invasive mechanical ventilation is a leading cause of death in critically ill cancer patients. The aim of this study was to evaluate the outcome and prognostic factors of patients requiring invasive mechanical ventilator for acute respiratory failure, within 1 month of ambulatory chemotherapy for solid cancer.

Methods

A retrospective observational study of patients who underwent ambulatory chemotherapy at Samsung Medical Center, between January of 2007 and April of 2009, was employed for this study.

Results

A total of 51 patients met the inclusion criteria and were included in the study. The median age was 65 years (25–87) and the majority of the patients were male (n = 38, 74.5 %). There were 42 patients (82.3 %) with lung cancer. The most common cause of acute respiratory failure was pneumonia (n = 24, 47.1 %), followed by acute respiratory failure due to extra-pulmonary infection, drug-induced pneumonitis, alveolar hemorrhage, and cancer progression. The intensive care unit (ICU) mortality was 68.6 % and the most common cause of death in the ICU was uncorrected cause of acute respiratory failure. Before adjustment for others factors, prechemotherapy Eastern Cooperative Oncology Group (ECOG) Performance Scale (PS) (P = 0.03), Sequential Organ Failure Assessment score (P = 0.01), and anemia (P = 0.04) were significantly associated with ICU mortality. However, when adjusted for age, sex, and Acute Physiologic and Chronic Health Evaluation II score, only poor ECOG PS (≥2) was significantly associated with ICU mortality [OR 6.36 (95 % CI (1.02–39.5))].

Conclusions

The outcome of patients with acute respiratory failure needing invasive mechanical ventilation during ambulatory chemotherapy for solid cancer is poor. Prechemotherapy performance status is an independent predictor of mortality.

Keywords

CancerChemotherapyIntensive care unitMortalityRespiratory failure

Copyright information

© Springer-Verlag Berlin Heidelberg 2013