Acute respiratory failure: mortality associated with underlying disease.

Area of Science:

• Critical Care Medicine
• Oncology
• Respiratory Medicine

Background:

• Prolonged mechanical ventilatory support is a critical intervention for severe respiratory failure.
• Admitting diagnosis may influence outcomes for intensive care unit (ICU) patients.

Purpose of the Study:

• To investigate if admitting diagnosis impacts mortality rates in patients requiring mechanical ventilation for over 72 hours.

Main Methods:

• Retrospective review of 98 patients requiring mechanical ventilatory support >72 hours.
• Comparison of outcomes between patients with malignant (cancer) diagnoses and nonmalignant diagnoses, including post-myocardial infarction and cardiorespiratory arrest admissions.

Main Results:

• No significant differences in multiple organ system failure, age, or length of ICU/hospital stay across groups.
• Significantly higher incidence of sepsis (p<0.05) and mortality (p<0.01) observed in the cancer patient group.

Conclusions:

• Cancer patients requiring prolonged mechanical ventilation have a substantially higher risk of sepsis and mortality.
• Patients with cancer and their families must be informed about the poor prognosis associated with prolonged acute respiratory failure.