IDEAS home Printed from https://ideas.repec.org/p/ulb/ulbeco/2013-313967.html
   My bibliography  Save this paper

Acute respiratory failure in immunocompromised patients: outcome and clinical features according to neutropenia status

Author

Listed:
  • Djamel Mokart
  • Michael Darmon
  • Peter Schellongowski
  • Peter Pickkers
  • Marcio Soares
  • Jordi Rello
  • Philippe P.R. Bauer
  • Andry Van de Louw
  • Virginie Lemiale
  • Fabio Taccone
  • Ignacio Martin-Loeches
  • Jorge Salluh
  • Katerina Rusinova
  • Sangeeta Mehta
  • Massimo Antonelli
  • Achille Kouatchet
  • Andreas Barratt-Due
  • Miia Valkonen
  • Precious Pearl Landburg
  • Ramin Brandt Bukan
  • Frédéric Pène
  • Victoria Metaxa
  • Gastón Burghi
  • Colombe Saillard
  • Lene L.B. Nielsen
  • Emmanuel Canet
  • Magali Bisbal
  • Elie Azoulay

Abstract

Background: The impact of neutropenia in critically ill immunocompromised patients admitted in a context of acute respiratory failure (ARF) remains uncertain. The primary objective was to assess the prognostic impact of neutropenia on outcomes of these patients. Secondary objective was to assess etiology of ARF according to neutropenia. Methods: We performed a post hoc analysis of a prospective multicenter multinational study from 23 ICUs belonging to the Nine-I network. Between November 2015 and July 2016, all adult immunocompromised patients with ARF admitted to the ICU were included in the study. Adjusted analyses included: (1) a hierarchical model with center as random effect; (2) propensity score (PS) matched cohort; and (3) adjusted analysis in the matched cohort. Results: Overall, 1481 patients were included in this study of which 165 had neutropenia at ICU admission (11%). ARF etiologies distribution was significantly different between neutropenic and non-neutropenic patients, main etiologies being bacterial pneumonia (48% vs 27% in neutropenic and non-neutropenic patients, respectively). Initial oxygenation strategy was standard supplemental oxygen in 755 patients (51%), high-flow nasal oxygen in 165 (11%), non-invasive ventilation in 202 (14%) and invasive mechanical ventilation in 359 (24%). Before adjustment, hospital mortality was significantly higher in neutropenic patients (54% vs 42%; p = 0.006). After adjustment for confounder and center effect, neutropenia was no longer associated with outcome (OR 1.40, 95% CI 0.93–2.11). Similar results were observed after matching (52% vs 46%, respectively; p = 0.35) and after adjustment in the matched cohort (OR 1.04; 95% CI 0.63–1.72). Conclusion: Neutropenia at ICU admission is not associated with hospital mortality in this cohort of critically ill immunocompromised patients admitted for ARF. In neutropenic patients, main ARF etiologies are bacterial and fungal infections.

Suggested Citation

  • Djamel Mokart & Michael Darmon & Peter Schellongowski & Peter Pickkers & Marcio Soares & Jordi Rello & Philippe P.R. Bauer & Andry Van de Louw & Virginie Lemiale & Fabio Taccone & Ignacio Martin-Loech, 2020. "Acute respiratory failure in immunocompromised patients: outcome and clinical features according to neutropenia status," ULB Institutional Repository 2013/313967, ULB -- Universite Libre de Bruxelles.
    • Handle: RePEc:ulb:ulbeco:2013/313967
    Note: SCOPUS: ar.j
    as

    Download full text from publisher

    File URL: https://dipot.ulb.ac.be/dspace/bitstream/2013/313967/1/doi_297611.pdf
    File Function: Full text for the whole work, or for a work part
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Adrien Contejean & Fabrice Bruneel & Antoine Rabbat & Pierre Perez & Anne-Pascale Meert & Dominique Benoit & Rébecca Hamidfar & Michael Darmon & Mercé Jourdain & Anne Renault & Benoît Schlemmer & Virg, 2016. "Increased mortality in hematological malignancy patients with acute respiratory failure from undetermined etiology: a Groupe de Recherche en Réanimation Respiratoire en Onco-Hématologique (Grrr-OH) st," ULB Institutional Repository 2013/243903, ULB -- Universite Libre de Bruxelles.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.

      More about this item

      Statistics

      Access and download statistics

      Corrections

      All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:ulb:ulbeco:2013/313967. See general information about how to correct material in RePEc.

      If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

      If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

      If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

      For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Benoit Pauwels (email available below). General contact details of provider: https://edirc.repec.org/data/ecsulbe.html .

      Please note that corrections may take a couple of weeks to filter through the various RePEc services.

      IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.