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Outcome for cancer patients requiring mechanical ventilation
J S Groeger1, P White, D M Nierman
1Memorial Sloan-Kettering Cancer Center, New York, NY, USA. groegerj@mskcc.org
Summary
Hospital survival for cancer patients requiring mechanical ventilation is low, with 76% mortality observed. A predictive model identifies key risk factors to guide treatment decisions for these critically ill cancer patients.
Area of Science:
- Critical Care Medicine
- Oncology
- Outcomes Research
Background:
- Mechanical ventilation is a life-sustaining intervention for critically ill patients.
- Cancer patients requiring mechanical ventilation represent a vulnerable population with complex care needs.
Purpose of the Study:
- To determine hospital survival rates for cancer patients requiring mechanical ventilation.
- To identify clinical factors associated with mortality in this patient group.
- To develop a predictive model for hospital survival.
Main Methods:
- Prospective, multicenter observational study at five academic tertiary care hospitals.
- Inclusion of 782 adult cancer patients initiated on mechanical ventilation.
- Collection of demographic and clinical variables, with hospital discharge vital status.
Main Results:
- Overall hospital mortality was 76% across study centers.
- Factors associated with increased mortality included intubation delay, leukemia, cancer progression, bone marrow transplant, arrhythmias, disseminated intravascular coagulation, and vasopressor use.
- Prior curative surgery was a protective factor.
Conclusions:
- A validated predictive model can estimate hospital survival for cancer patients on mechanical ventilation.
- This model can aid in treatment planning and shared decision-making.
- Further validation in diverse settings is recommended.