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Risk factors for acute organ failure in intensive care unit patients who receive respiratory support in the absence of non-respiratory organ failure: an international prospective cohort study.

Terblanche, M; Kruger, P; di Gangi, S; Gearay, S; Gilfeather, L; Ferguson, ND; Pearse, R; Beale, R; Rhodes, A; Brett, SJ; et al. Terblanche, M; Kruger, P; di Gangi, S; Gearay, S; Gilfeather, L; Ferguson, ND; Pearse, R; Beale, R; Rhodes, A; Brett, SJ; McAuley, DF (2012) Risk factors for acute organ failure in intensive care unit patients who receive respiratory support in the absence of non-respiratory organ failure: an international prospective cohort study. Crit Care, 16 (2). R61. ISSN 1466-609X https://doi.org/10.1186/cc11306
SGUL Authors: Rhodes, Andrew

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Abstract

INTRODUCTION: Many supposed low-risk intensive care unit (ICU) admissions develop acute organ failure (AOF). Identifying patients at high risk of developing AOF and targeting them with preventative strategies may be effective. Our study question was: in a population of ICU patients receiving positive pressure respiratory support (invasive or non-invasive) in the absence of non-respiratory AOF, what is the 14-day incidence of, risk factors for and time to acute organ failure? METHODS: In an international prospective cohort study, patients receiving positive pressure respiratory support (invasive or non-invasive) in the absence of non-respiratory AOF were enrolled and followed for 14 days. The primary outcome measure was the incidence of any AOF (defined as SOFA 3 to 4) during follow-up. RESULTS: A total of 123 of 766 screened patients (16.1%) were enrolled. Data are reported for 121 patients. In total, 45 out of 121 patients (37.2%) developed AOF. Mortality rates were higher in those with AOF: 17.8% versus 4.0% OR 5.11, P = 0.019) for ICU mortality; and 28.9% versus 11.8% (OR 2.80, P = 0.019) for hospital mortality. Median ICU length of stay was also longer in those with AOF (11 versus 3.0 days; P < 0.0001). Hypoxemic respiratory failure (P = 0.001) and cardiovascular dysfunction (that is, SOFA 1 to 2; P = 0.03) were associated with AOF. The median time to first AOF was two days. CONCLUSIONS: Patients receiving positive (invasive or non-invasive) pressure respiratory support in the absence of non-respiratory AOF are commonly admitted to ICU; AOF is frequent in these patients. Organ failure developed within a short period after admission. Hypoxemic respiratory failure and cardiovascular dysfunction were strongly associated with AOF.

Item Type: Article
Additional Information: © 2012 Terblanche et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: APACHE, Acute Disease, Australia, Canada, Female, Humans, Incidence, Intensive Care Units, Male, Middle Aged, Multiple Organ Failure, Positive-Pressure Respiration, Prospective Studies, Regression Analysis, Risk Assessment, Risk Factors, United Kingdom, Humans, Acute Disease, Multiple Organ Failure, Positive-Pressure Respiration, APACHE, Incidence, Risk Assessment, Risk Factors, Regression Analysis, Prospective Studies, Middle Aged, Intensive Care Units, Canada, Australia, Female, Male, United Kingdom, 11 Medical And Health Sciences, Emergency & Critical Care Medicine
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Cell Sciences (INCCCS)
Journal or Publication Title: Crit Care
ISSN: 1466-609X
Language: eng
Dates:
DateEvent
18 April 2012Published
18 April 2012Accepted
Publisher License: Creative Commons: Attribution 2.0
Projects:
Project IDFunderFunder ID
CS/08/08/17Department of Healthhttp://dx.doi.org/10.13039/501100000276
PubMed ID: 22512834
Web of Science ID: WOS:000313196800027
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/110376
Publisher's version: https://doi.org/10.1186/cc11306

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