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Determinants of mortality for adults with cystic fibrosis admitted in Intensive Care Unit: a multicenter study
- Source :
- Respiratory Research, Respiratory Research, BioMed Central, 2006, 7, pp.14. ⟨10.1186/1465-9921-7-14⟩, Respiratory Research, Vol 7, Iss 1, p 14 (2006), Respiratory Research, 2006, 7, pp.14. ⟨10.1186/1465-9921-7-14⟩, Respir Res, Respir Res, 2006, 7, pp.14. 〈10.1186/1465-9921-7-14〉
- Publication Year :
- 2006
- Publisher :
- HAL CCSD, 2006.
-
Abstract
- Background Intensive care unit (ICU) admission of adults with cystic fibrosis (CF) is controversial because of poor outcome. This appraisal needs re-evaluation following recent changes in both CF management and ICU daily practice. Objectives were to determine long-term outcome of adults with CF admitted in ICU and to identify prognostic factors. Methods Retrospective multicenter study of 60 ICU hospitalizations for 42 adult CF patients admitted between 2000 and 2003. Reason for ICU admission, ventilatory support provided and one-year survival were recorded. Multiple logistic analysis was used to determine predictors of mortality. Results Prior to ICU admission, all patients (mean age 28.1 ± 8 yr) had a severe lung disease (mean FEV1 28 ± 12% predicted; mean PaCO2 47 ± 9 mmHg). Main reason for ICU hospitalization was pulmonary infective exacerbation (40/60). At admission, noninvasive ventilation was used in 57% of cases and was successful in 67% of patients. Endotracheal intubation was implemented in 19 episodes. Overall ICU mortality rate was 14%. One year after ICU discharge, 10 of the 28 survivors have been lung transplanted. Among recognized markers of CF disease severity, only the annual FEV1 loss was associated with a poor outcome (HR = 1.47 [1.18–1.85], p = 0.001). SAPSII (HR = 1.08 [1.03–1.12], p < 0.001) and endotracheal intubation (HR = 16.60 [4.35–63.34], p < 0.001) were identified as strong independent predictors of mortality. Conclusion Despite advanced lung disease, adult patients with CF admitted in ICU have high survival rate. Endotracheal intubation is associated with a poor prognosis and should be used as the last alternative. Although efforts have to be made in selecting patients with CF likely to benefit from ICU resources, ICU admission of these patients should be considered.
- Subjects :
- Male
Exacerbation
Cystic Fibrosis
MESH: Risk Assessment
Cystic fibrosis
MESH : Intensive Care
[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
law.invention
MESH: Proportional Hazards Models
0302 clinical medicine
law
Risk Factors
MESH: Risk Factors
Outcome Assessment, Health Care
MESH : Female
030212 general & internal medicine
MESH : Risk Assessment
MESH: Respiration, Artificial
MESH : Prognosis
MESH : Adult
MESH : Survival Rate
Prognosis
Intensive care unit
MESH : Risk Factors
3. Good health
Survival Rate
Intensive Care Units
medicine.anatomical_structure
MESH: Survival Analysis
Female
France
MESH : Intensive Care Units
Pulmonary and Respiratory Medicine
Adult
medicine.medical_specialty
MESH : Outcome Assessment (Health Care)
Critical Care
MESH: Cystic Fibrosis
MESH: Survival Rate
MESH : Male
Risk Assessment
MESH: Prognosis
03 medical and health sciences
Intensive care
MESH : Cystic Fibrosis
medicine
Humans
MESH: Intensive Care
MESH : Respiration, Artificial
Intensive care medicine
MESH : France
Survival rate
MESH: Outcome Assessment (Health Care)
Survival analysis
Proportional Hazards Models
lcsh:RC705-779
Lung
MESH: Humans
Proportional hazards model
business.industry
Research
MESH : Humans
MESH: Adult
lcsh:Diseases of the respiratory system
medicine.disease
MESH : Proportional Hazards Models
Respiration, Artificial
Survival Analysis
MESH: Male
MESH: France
030228 respiratory system
Emergency medicine
[SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
MESH: Intensive Care Units
MESH : Survival Analysis
business
MESH: Female
[ SDV.MHEP.PSR ] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
Subjects
Details
- Language :
- English
- ISSN :
- 14659921
- Database :
- OpenAIRE
- Journal :
- Respiratory Research, Respiratory Research, BioMed Central, 2006, 7, pp.14. ⟨10.1186/1465-9921-7-14⟩, Respiratory Research, Vol 7, Iss 1, p 14 (2006), Respiratory Research, 2006, 7, pp.14. ⟨10.1186/1465-9921-7-14⟩, Respir Res, Respir Res, 2006, 7, pp.14. 〈10.1186/1465-9921-7-14〉
- Accession number :
- edsair.doi.dedup.....c57f44ba7335f840656f27241141312b