The Prognostic Factors of Mortality due to Post-Operative Acute Respiratory Failure in Carcinoma Patients_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 XU Haiyan , GAO Yong , XIAO Qinglong , SUN Kelin

Intensive Care Unit, Cancer Hospital,Chinese Academy of Medical Sciences. Beijing, 100021, China Corresponding Author: XU Hai-yan, E-mail: xuhaiyan7609@ sina. com;

Corresponding author：

XU Haiyan, Email: xuhaiyan7609@sina.com

Keywords：

Respiratory failure; Mortality; Prognostic factors

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Objective To study the mortality and prognostic factors of post-operative acute respiratory failure in cancer patients. Methods There were 1632 postoperative cancer patients from2004 to 2006 in the ICU of Cancer Hospital, in which 447 patients were complicated with acute respiratory failure ( intubation or tracheotomy and mechanical ventilation) . The clinical data was retrospectively analyzed. Stepwise logistic regression analysis was used to identify variables associated with mortality for acute respiratory failure. Results In 447 patients with acute respiratory failure ( male 260, female 187) , 106 cases died with a mortality of 6. 5% . Single factor analysis showed that acute morbodities ( shock, infection, organ failure) , intervention ( continuous renal replacement therapy, vasopressor drugs) , the 28-day ICU free days and APACHE scores ( ≥ 20) had significant differences between the survivor and non-survivor. Multiple logistic regression analysis showed that duration of operation( P = 0. 008, OR 1. 032, 95% CI 1. 008-1. 057) , APACHEⅡ≥20 scores( P =0. 000, OR12. 200, 95% CI 2. 896-51. 406) , organ function failure( P =0. 000, OR 13. 344,95% CI 3. 791-7. 395) were associated with mortality of acute respiratory failure. Conclusion Duration of operation, organ function failure, and APACHE Ⅱ scores were risk prognostic factors for postoperative cancer patients with acute respiratory failure.

Citation： XU Haiyan,GAO Yong,XIAO Qinglong,SUN Kelin. The Prognostic Factors of Mortality due to Post-Operative Acute Respiratory Failure in Carcinoma Patients. Chinese Journal of Respiratory and Critical Care Medicine, 2009, 09(5): 469-472. doi: Copy

1.	Vincent JL, SakrY, Ranieri VM. Epidemiology and outcome of acute respiratory failure in intensive care unit patients. Crit Care Med, 2003, 31: S296-S299.
2.	Bernard GR, Artigas A, Brigham KL, et al. The American- European Consensus Conference of ARDS: definition, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med, 1994, 149: 814-818.
3.	Bone RC, Balk RA, Cerra FB, et al. American College of Chest Physician /Society of Critical Care Medicine Consensus Conference. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest, 1992, 101: 1644-1655.
4.	Knaus WA, Draper EA, Wagner DP, et al. APACHE II: a severity of disease classification system. Crit Care Med, 1985, 13: 818-829.
5.	Pascual FE, Matthay MA, Bacchetti P, et al. Assessment of Prognosis in Patients With Community-Acquired Pneumonia Who Require Mechanical Ventilation. Chest, 2000, 117: 503-512.
6.	Vincent JL, Moreno R, Takala J, et al. The SOFA ( Sepsis-related Organ Failure Assessment ) score to describe organ dysfunction/ failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med, 1996, 22: 707-710.
7.	Luhr OR, Antonsen K, Karlsson M, et al. Incidence and mortality after acute respiratory failure and acute respiratory distress syndrome in Sweden, Denmark, and Iceland. The ARF Study Group. Am J Respir Crit Care Med, 1999, 159: 1849-1861.
8.	Lewandowski K, Metz J, Deutschmann C, et al. Incidence, severity, and mortality of acute respiratory failure in Berlin, Germany. Am J Respir Crit Care Med, 1995, 151: 1121-1125.
9.	Vasilyev S, Schaap RN, Mortensen JD. Hospital survival rates of patients with acute respiratory failure in modern respiratory intensive care units. An international, multicenter, prospective survey. Chest, 1995, 107: 1083-1088.
10.	陈谐捷, 唐小平, 尹炽标, 等.
11.	宋鹏, 李琦, 王长征, 等.
12.	Knaus WA, Sun X, Hakim RB, et al. Evaluation of definitions for adult respiratory distress syndrome. Am J Respir Crit Care Med, 1994, 150: 311-317.
13.	Epstein SK, Vuong V. Lack of Influence of Gender on Outcomes of Mechanically Ventilated Medical ICU Patients. Chest, 1999, 116 : 732-739.
14.	Montaner JS, Hawley PH, Ronco JJ, et al. Multisystem organ failure predicts mortality of ICU patients with acute respiratory failure second to AIDS-related PCP. Chest, 1992, 102: 1823-1828.
15.	Licker M, Spiliopoulos A, Frey JG, et al. Management and outcome of patients undergoing thoracic surgery in a regional chest medical centre. Eur J Anaesthesiol, 2001, 18: 540-547.
16.	Ferring M, Vincent JL. Is outcome from ARDS related to the severity of respiratory failure? Eur Respir J, 1997, 10: 1297-1300.
17.	例重症急性呼吸窘迫综合征临床资料回顾性分析. 中国呼吸与危重监护杂志, 2006, 5: 35-38.
18.	DiRusso SM, Nelson LD, Safcsak K, et al. Survival in patients with severe adult respiratory distress syndrome treated with high-level positive end-expiratory pressure. Crit Care Med, 1995, 23: 1485-1496.
19.	例严重急性呼吸综合征死亡病例的临床分析. 中国呼吸与危重监护杂志, 2003, 2: 206-210.

1. Vincent JL, SakrY, Ranieri VM. Epidemiology and outcome of acute respiratory failure in intensive care unit patients. Crit Care Med, 2003, 31: S296-S299.
2. Bernard GR, Artigas A, Brigham KL, et al. The American- European Consensus Conference of ARDS: definition, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med, 1994, 149: 814-818.
3. Bone RC, Balk RA, Cerra FB, et al. American College of Chest Physician /Society of Critical Care Medicine Consensus Conference. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest, 1992, 101: 1644-1655.
4. Knaus WA, Draper EA, Wagner DP, et al. APACHE II: a severity of disease classification system. Crit Care Med, 1985, 13: 818-829.
5. Pascual FE, Matthay MA, Bacchetti P, et al. Assessment of Prognosis in Patients With Community-Acquired Pneumonia Who Require Mechanical Ventilation. Chest, 2000, 117: 503-512.
6. Vincent JL, Moreno R, Takala J, et al. The SOFA ( Sepsis-related Organ Failure Assessment ) score to describe organ dysfunction/ failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med, 1996, 22: 707-710.
7. Luhr OR, Antonsen K, Karlsson M, et al. Incidence and mortality after acute respiratory failure and acute respiratory distress syndrome in Sweden, Denmark, and Iceland. The ARF Study Group. Am J Respir Crit Care Med, 1999, 159: 1849-1861.
8. Lewandowski K, Metz J, Deutschmann C, et al. Incidence, severity, and mortality of acute respiratory failure in Berlin, Germany. Am J Respir Crit Care Med, 1995, 151: 1121-1125.
9. Vasilyev S, Schaap RN, Mortensen JD. Hospital survival rates of patients with acute respiratory failure in modern respiratory intensive care units. An international, multicenter, prospective survey. Chest, 1995, 107: 1083-1088.
10. 陈谐捷, 唐小平, 尹炽标, 等.
11. 宋鹏, 李琦, 王长征, 等.
12. Knaus WA, Sun X, Hakim RB, et al. Evaluation of definitions for adult respiratory distress syndrome. Am J Respir Crit Care Med, 1994, 150: 311-317.
13. Epstein SK, Vuong V. Lack of Influence of Gender on Outcomes of Mechanically Ventilated Medical ICU Patients. Chest, 1999, 116 : 732-739.
14. Montaner JS, Hawley PH, Ronco JJ, et al. Multisystem organ failure predicts mortality of ICU patients with acute respiratory failure second to AIDS-related PCP. Chest, 1992, 102: 1823-1828.
15. Licker M, Spiliopoulos A, Frey JG, et al. Management and outcome of patients undergoing thoracic surgery in a regional chest medical centre. Eur J Anaesthesiol, 2001, 18: 540-547.
16. Ferring M, Vincent JL. Is outcome from ARDS related to the severity of respiratory failure? Eur Respir J, 1997, 10: 1297-1300.
17. 例重症急性呼吸窘迫综合征临床资料回顾性分析. 中国呼吸与危重监护杂志, 2006, 5: 35-38.
18. DiRusso SM, Nelson LD, Safcsak K, et al. Survival in patients with severe adult respiratory distress syndrome treated with high-level positive end-expiratory pressure. Crit Care Med, 1995, 23: 1485-1496.
19. 例严重急性呼吸综合征死亡病例的临床分析. 中国呼吸与危重监护杂志, 2003, 2: 206-210.

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