دورية أكاديمية
End of life decisions in immunocompromised patients with acute respiratory failure
| العنوان: | End of life decisions in immunocompromised patients with acute respiratory failure |
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| المؤلفون: | Burghi, Gaston, Metaxa, Victoria, Pickkers, Peter, Soares, Marcio, Rello, Jordi, Bauer, Philippe, van de Louw, Andry, Taccone, Fabio Silvio, Loeches, Ignacio Martin, Schellongowski, Peter, Rusinova, Katerina, Antonelli, Massimo, Kouatchet, Achille, Barratt-Due, Andreas, Valkonen, Miia, Pène, Frédéric, Mokart, Djamel, Jaber, Samir, Azoulay, Elie, de Jong, Audrey |
| المساهمون: | Universidad de Montevideo, University College London Hospitals (UCLH), Radboud University Medical Center Nijmegen, Universitat Autònoma de Barcelona = Autonomous University of Barcelona = Universidad Autónoma de Barcelona (UAB), Mayo Clinic Rochester, Pennsylvania State University (Penn State), Penn State System, Université libre de Bruxelles (ULB), St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Medizinische Universität Wien = Medical University of Vienna, Medicine Charles University and General Faculty Hospital in Prague, Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart Roma (Unicatt), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Oslo University Hospital Oslo, Helsinki University Hospital Finland (HUS), Hôpital Cochin AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Paris 5 (UPD5), Institut Paoli-Calmettes (IPC), Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Physiologie & médecine expérimentale du Cœur et des Muscles U 1046 (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Hopital Saint-Louis AP-HP (AP-HP), Université Paris Diderot, Sorbonne Paris Cité, Paris, France, Université Paris Diderot - Paris 7 (UPD7) |
| المصدر: | ISSN: 0883-9441 ; Journal of Critical Care ; https://hal.science/hal-03784943Test ; Journal of Critical Care, 2022, 72, pp.154152. ⟨10.1016/j.jcrc.2022.154152⟩. |
| بيانات النشر: | HAL CCSD WB Saunders |
| سنة النشر: | 2022 |
| المجموعة: | Université de Montpellier: HAL |
| مصطلحات موضوعية: | Decisions to forgo life-sustaining therapies, Hematological malignancies, Transplantation, Systemic diseases, Pneumocystis, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie |
| الوصف: | International audience ; Purpose: To identify patient, disease and organizational factors associated with decisions to forgo life-sustaining therapies (DFLSTs) in critically ill immunocompromised patients admitted to the intensive care unit (ICU) for acute respiratory failure.Material and methods: We performed a secondary analysis of the international EFRAIM prospective study, which enrolled 1611 immunocompromised patients with acute respiratory failure admitted to 68 ICUs in 16 countries between October 2015 and June 2016. Multivariate logistic analysis was performed to identify independent predictors of DFLSTs.Results: The main causes of immunosuppression were hematological malignancies (50%) and solid tumor (38%). Patients had a median age of 63 yo (54–71). A pulmonologist was involved in the patient management in 38% of cases. DFLSTs had been implemented in 28% of the patients. The following variables were independently associated with DFLSTs: 1) patient-related: older age (OR 1.02 per one year increase, 95% confidence interval(CI) 1.01–1.03,P < 0.001), poor performance status (OR 2.79, 95% CI 1.98–3.93, P < 0.001); 2) disease-related: shock (OR 2.00, 95% CI 1.45–2.75, P < 0.001), liver failure (OR 1.59, 95% CI 1.14–2.21, P = 0.006), invasive mechanical ventilation (OR 1.79, 95% CI 1.31–2.46, P < 0.001); 3) organizational: having a pulmonologist involved in patient management (OR 1.85, 95% CI 1.36–2.52, P < 0.001), and the presence of a critical care outreach services (OR 1.63, 95% CI 1.11–2.38, P = 0.012).Conclusions: A DFLST is made in one in four immunocompromised patient admitted to the ICU for acute respiratory failure. Involving a pulmonologist in patient's management is associated with less non beneficial care. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/36137351; hal-03784943; https://hal.science/hal-03784943Test; https://hal.science/hal-03784943/documentTest; https://hal.science/hal-03784943/file/2022%20Burghi%20et%20al%20End%20of%20life.pdfTest; PUBMED: 36137351 |
| DOI: | 10.1016/j.jcrc.2022.154152 |
| الإتاحة: | https://doi.org/10.1016/j.jcrc.2022.154152Test https://hal.science/hal-03784943Test https://hal.science/hal-03784943/documentTest https://hal.science/hal-03784943/file/2022%20Burghi%20et%20al%20End%20of%20life.pdfTest |
| حقوق: | info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.FE282E65 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.jcrc.2022.154152 |
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