Weaning outcome of solid cancer patients requiring mechanical ventilation in the intensive care unit
Background: Whether the weaning outcome of solid cancer patients receiving mechanical ventilation (MV) in the intensive care unit (ICU) is comparable to that in non-cancer patients is unknown. The aim of this study was to compare the weaning outcomes between non-cancer patients and patients with dif...
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| Format: | Article |
| Language: | English |
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Elsevier
2019-06-01
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| Series: | Journal of the Formosan Medical Association |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664618307071 |
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Article |
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DOAJ |
| language |
English |
| format |
Article |
| sources |
DOAJ |
| author |
Emily Han-Chung Hsiue Pei-Lin Lee Yung-Hsuan Chen Ting-Hui Wu Chiao-Feng Cheng Keng-Man Cheng Po-Chun Yang Hsing-Wu Chen Pei-Yu Lin Dai-Lung Chiang Huey-Dong Wu James Chih-Hsin Yang Chong-Jen Yu |
| spellingShingle |
Emily Han-Chung Hsiue Pei-Lin Lee Yung-Hsuan Chen Ting-Hui Wu Chiao-Feng Cheng Keng-Man Cheng Po-Chun Yang Hsing-Wu Chen Pei-Yu Lin Dai-Lung Chiang Huey-Dong Wu James Chih-Hsin Yang Chong-Jen Yu Weaning outcome of solid cancer patients requiring mechanical ventilation in the intensive care unit Journal of the Formosan Medical Association |
| author_facet |
Emily Han-Chung Hsiue Pei-Lin Lee Yung-Hsuan Chen Ting-Hui Wu Chiao-Feng Cheng Keng-Man Cheng Po-Chun Yang Hsing-Wu Chen Pei-Yu Lin Dai-Lung Chiang Huey-Dong Wu James Chih-Hsin Yang Chong-Jen Yu |
| author_sort |
Emily Han-Chung Hsiue |
| title |
Weaning outcome of solid cancer patients requiring mechanical ventilation in the intensive care unit |
| title_short |
Weaning outcome of solid cancer patients requiring mechanical ventilation in the intensive care unit |
| title_full |
Weaning outcome of solid cancer patients requiring mechanical ventilation in the intensive care unit |
| title_fullStr |
Weaning outcome of solid cancer patients requiring mechanical ventilation in the intensive care unit |
| title_full_unstemmed |
Weaning outcome of solid cancer patients requiring mechanical ventilation in the intensive care unit |
| title_sort |
weaning outcome of solid cancer patients requiring mechanical ventilation in the intensive care unit |
| publisher |
Elsevier |
| series |
Journal of the Formosan Medical Association |
| issn |
0929-6646 |
| publishDate |
2019-06-01 |
| description |
Background: Whether the weaning outcome of solid cancer patients receiving mechanical ventilation (MV) in the intensive care unit (ICU) is comparable to that in non-cancer patients is unknown. The aim of this study was to compare the weaning outcomes between non-cancer patients and patients with different types of cancer. Methods: We studied patients requiring MV during ICU stay for medical reasons between 2012 and 2014. Cancer patients were grouped into those with lung cancer (LC), head and neck cancer (HNC), hepatocellular carcinoma (HCC), and other cancers (OC). The primary endpoint was successful weaning at day 90 after the initiation of MV, and the main secondary endpoints were 28-day and 90-day mortality after ICU admission. Results: Five hundred and eighteen patients with solid cancers and 1362 non-cancer patients were recruited. The rate of successful weaning at day 90 was 57.9% in cancer patients, which was lower than 68.9% in non-cancer patients (p < 0.001). Compared to non-cancer patients, LC was associated with a lower probability of weaning at day 90 (hazard ratio 0.565, 95% CI 0.446 to 0.715), while HNC, HCC, and OC had similar probabilities. The 28-day and 90-day mortality rates were higher in cancer patients than in non-cancer patients (45.2% vs. 29.4%, and 65.6% vs. 37.7%, respectively, both p < 0.001). Conclusion: Among mechanically ventilated patients in the ICU, those with LC were associated with a lower probability of weaning at day 90 compared to non-cancer patients. Keywords: Cancer, Intensive care unit, Mechanical ventilation, Weaning |
| url |
http://www.sciencedirect.com/science/article/pii/S0929664618307071 |
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doaj-d54747dbc0ce424a9c2e5e87c53df0042020-11-25T02:44:10ZengElsevierJournal of the Formosan Medical Association0929-66462019-06-0111869951004Weaning outcome of solid cancer patients requiring mechanical ventilation in the intensive care unitEmily Han-Chung Hsiue0Pei-Lin Lee1Yung-Hsuan Chen2Ting-Hui Wu3Chiao-Feng Cheng4Keng-Man Cheng5Po-Chun Yang6Hsing-Wu Chen7Pei-Yu Lin8Dai-Lung Chiang9Huey-Dong Wu10James Chih-Hsin Yang11Chong-Jen Yu12Department of Oncology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan; Cellular and Molecular Medicine Program, Johns Hopkins School of Medicine, Suite 2-103, 1830 East Monument St, Baltimore, MD, 21205, USADepartment of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan; Center of Sleep Disorder, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan; Center for Electronics Technology Integration, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan; Corresponding author. Department of Internal Medicine, Center of Sleep Disorder, National Taiwan University Hospital, Taipei, Taiwan, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan. Fax: +886 2 23582867.Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, TaiwanDepartment of Oncology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USADepartment of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, TaiwanDepartment of Oncology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, TaiwanDepartment of Oncology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, TaiwanDepartment of Oncology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, TaiwanGraduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, No.1, Sec.4, Roosevelt Road, Taipei, TaiwanDepartment of Integrated Diagnostics and Therapeutics, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, TaiwanDepartment of Oncology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan; Department of Medical Research, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, No. 1, Sec. 1, Ren-Ai Rd, 100, Taipei, Taiwan; National Taiwan University Cancer Center, No. 1, Sec. 1, Ren-Ai Rd, Taipei, 100, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan; Center of Sleep Disorder, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, TaiwanBackground: Whether the weaning outcome of solid cancer patients receiving mechanical ventilation (MV) in the intensive care unit (ICU) is comparable to that in non-cancer patients is unknown. The aim of this study was to compare the weaning outcomes between non-cancer patients and patients with different types of cancer. Methods: We studied patients requiring MV during ICU stay for medical reasons between 2012 and 2014. Cancer patients were grouped into those with lung cancer (LC), head and neck cancer (HNC), hepatocellular carcinoma (HCC), and other cancers (OC). The primary endpoint was successful weaning at day 90 after the initiation of MV, and the main secondary endpoints were 28-day and 90-day mortality after ICU admission. Results: Five hundred and eighteen patients with solid cancers and 1362 non-cancer patients were recruited. The rate of successful weaning at day 90 was 57.9% in cancer patients, which was lower than 68.9% in non-cancer patients (p < 0.001). Compared to non-cancer patients, LC was associated with a lower probability of weaning at day 90 (hazard ratio 0.565, 95% CI 0.446 to 0.715), while HNC, HCC, and OC had similar probabilities. The 28-day and 90-day mortality rates were higher in cancer patients than in non-cancer patients (45.2% vs. 29.4%, and 65.6% vs. 37.7%, respectively, both p < 0.001). Conclusion: Among mechanically ventilated patients in the ICU, those with LC were associated with a lower probability of weaning at day 90 compared to non-cancer patients. Keywords: Cancer, Intensive care unit, Mechanical ventilation, Weaninghttp://www.sciencedirect.com/science/article/pii/S0929664618307071 |