Outcomes of hematopoietic cell transplant recipients requiring invasive mechanical ventilation : a two-centre retrospective cohort study
PURPOSE: Outcomes of critically ill, hematopoietic cell transplant patients who require prolonged mechanical ventilation are not well studied. We describe the baseline characteristics, critical care management, and outcomes of this population and explore potential predictors of mortality.
METHODS: We performed a retrospective cohort study in two critical care units in Ontario. We included adult intensive care unit patients who required invasive mechanical ventilation within 90 days of receiving a hematopoietic cell transplant. The primary outcome was mortality at 90 days. Using logistic regression, we explored predictors of mortality including type of transplant (allogeneic vs autologous), severity of illness (assessed using the Sequential Organ Failure Assessment [SOFA] score), and baseline characteristics (such as age and sex).
RESULTS: We included 70 patients from two study sites. Ninety-day mortality was 73% (n = 51) in the entire cohort, 58% (15/26) in patients post-autologous transplant, and 82% (36/44) in those post-allogeneic transplant. Ninety-one percent (10/11) of patients who required invasive mechanical ventilation for more than 21 days died. Independent predictors of all-cause mortality included allogeneic transplant, higher SOFA score, the presence of acute hypoxemic respiratory failure, and a longer interval between receiving the transplant and initiation of mechanical ventilation.
CONCLUSIONS: Our study shows high rates of mortality among hematopoietic cell transplant recipients that require invasive mechanical ventilation, particularly in those post-allogeneic transplant and in those who require prolonged ventilation for more than 21 days.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:66 |
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| Enthalten in: |
Canadian journal of anaesthesia = Journal canadien d'anesthesie - 66(2019), 12 vom: 09. Dez., Seite 1450-1457 |
| Sprache: |
Englisch |
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| Weiterer Titel: |
Pronostics des récipiendaires de transplantations de cellules hématopoïétiques nécessitant une ventilation mécanique invasive : une étude de cohorte rétrospective dans deux centres |
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| Beteiligte Personen: |
Hamidi, Mohammad [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 26.10.2020 Date Revised 26.10.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s12630-019-01439-z |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 245 | 1 | 0 | |a Outcomes of hematopoietic cell transplant recipients requiring invasive mechanical ventilation |b a two-centre retrospective cohort study |
| 246 | 3 | 3 | |a Pronostics des récipiendaires de transplantations de cellules hématopoïétiques nécessitant une ventilation mécanique invasive : une étude de cohorte rétrospective dans deux centres |
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| 500 | |a Date Revised 26.10.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a PURPOSE: Outcomes of critically ill, hematopoietic cell transplant patients who require prolonged mechanical ventilation are not well studied. We describe the baseline characteristics, critical care management, and outcomes of this population and explore potential predictors of mortality | ||
| 520 | |a METHODS: We performed a retrospective cohort study in two critical care units in Ontario. We included adult intensive care unit patients who required invasive mechanical ventilation within 90 days of receiving a hematopoietic cell transplant. The primary outcome was mortality at 90 days. Using logistic regression, we explored predictors of mortality including type of transplant (allogeneic vs autologous), severity of illness (assessed using the Sequential Organ Failure Assessment [SOFA] score), and baseline characteristics (such as age and sex) | ||
| 520 | |a RESULTS: We included 70 patients from two study sites. Ninety-day mortality was 73% (n = 51) in the entire cohort, 58% (15/26) in patients post-autologous transplant, and 82% (36/44) in those post-allogeneic transplant. Ninety-one percent (10/11) of patients who required invasive mechanical ventilation for more than 21 days died. Independent predictors of all-cause mortality included allogeneic transplant, higher SOFA score, the presence of acute hypoxemic respiratory failure, and a longer interval between receiving the transplant and initiation of mechanical ventilation | ||
| 520 | |a CONCLUSIONS: Our study shows high rates of mortality among hematopoietic cell transplant recipients that require invasive mechanical ventilation, particularly in those post-allogeneic transplant and in those who require prolonged ventilation for more than 21 days | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Ferreyro, Bruno L |e verfasserin |4 aut | |
| 700 | 1 | |a Angriman, Federico |e verfasserin |4 aut | |
| 700 | 1 | |a Rochwerg, Bram |e verfasserin |4 aut | |
| 700 | 1 | |a Mehta, Sangeeta |e verfasserin |4 aut | |
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