دورية أكاديمية
The association between nutritional risk index and ICU outcomes across hematologic malignancy patients with acute respiratory failure.
العنوان: | The association between nutritional risk index and ICU outcomes across hematologic malignancy patients with acute respiratory failure. |
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المؤلفون: | Kundu R; Interdepartmental Division of Critical Care Medicine, Department of Medicine, Mount Sinai Hospital/University Health Network, University of Toronto, 600 University Avenue, 18-206, Toronto, ON, M5G 1X5, Canada., Seeger R; Interdepartmental Division of Critical Care Medicine, Department of Medicine, Mount Sinai Hospital/University Health Network, University of Toronto, 600 University Avenue, 18-206, Toronto, ON, M5G 1X5, Canada., Elfassy MD; Interdepartmental Division of Critical Care Medicine, Department of Medicine, Mount Sinai Hospital/University Health Network, University of Toronto, 600 University Avenue, 18-206, Toronto, ON, M5G 1X5, Canada., Rozenberg D; Division of Respirology, Temerty Faculty of Medicine, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, Canada., Ahluwalia N; Interdepartmental Division of Critical Care Medicine, Department of Medicine, Mount Sinai Hospital/University Health Network, University of Toronto, 600 University Avenue, 18-206, Toronto, ON, M5G 1X5, Canada., Detsky ME; Interdepartmental Division of Critical Care Medicine, Department of Medicine, Mount Sinai Hospital/University Health Network, University of Toronto, 600 University Avenue, 18-206, Toronto, ON, M5G 1X5, Canada., Ferreyro BL; Interdepartmental Division of Critical Care Medicine, Department of Medicine, Mount Sinai Hospital/University Health Network, University of Toronto, 600 University Avenue, 18-206, Toronto, ON, M5G 1X5, Canada., Mehta S; Interdepartmental Division of Critical Care Medicine, Department of Medicine, Mount Sinai Hospital/University Health Network, University of Toronto, 600 University Avenue, 18-206, Toronto, ON, M5G 1X5, Canada., Law AD; Division of Medical Oncology/Hematology, Department of Medicine, Malignant HematologyPrincess Margaret Cancer Center, Toronto, Canada., Minden M; Division of Medical Oncology/Hematology, Department of Medicine, Malignant HematologyPrincess Margaret Cancer Center, Toronto, Canada., Prica A; Division of Medical Oncology/Hematology, Department of Medicine, Malignant HematologyPrincess Margaret Cancer Center, Toronto, Canada., Sklar M; Interdepartmental Division of Critical Care Medicine, Department of Medicine, Mount Sinai Hospital/University Health Network, University of Toronto, 600 University Avenue, 18-206, Toronto, ON, M5G 1X5, Canada., Munshi L; Interdepartmental Division of Critical Care Medicine, Department of Medicine, Mount Sinai Hospital/University Health Network, University of Toronto, 600 University Avenue, 18-206, Toronto, ON, M5G 1X5, Canada. Laveena.munshi@sinaihealth.ca.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. Laveena.munshi@sinaihealth.ca. |
المصدر: | Annals of hematology [Ann Hematol] 2023 Feb; Vol. 102 (2), pp. 439-445. Date of Electronic Publication: 2022 Dec 21. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Springer Verlag Country of Publication: Germany NLM ID: 9107334 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-0584 (Electronic) Linking ISSN: 09395555 NLM ISO Abbreviation: Ann Hematol Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Berlin : Springer Verlag Original Publication: Berlin ; New York : Springer International, c1991- |
مواضيع طبية MeSH: | Hematopoietic Stem Cell Transplantation* , Hematologic Neoplasms* , Respiratory Distress Syndrome* , Malnutrition*/complications , Respiratory Insufficiency*/etiology , Respiratory Insufficiency*/therapy , Leukemia, Myeloid, Acute*/complications, Female ; Humans ; Aged ; Middle Aged ; Male ; Retrospective Studies ; Intensive Care Units |
مستخلص: | Patients with hematological malignancies (HM) are at risk of acute respiratory failure (ARF). Malnutrition, a common association with HM, has the potential to influence ICU outcomes. Geriatric nutritional risk index (G-NRI) is a score derived from albumin and weight, which reflects risk of protein-energy malnutrition. We evaluated the association between G-NRI at ICU admission and ICU mortality in HM patients with ARF. We conducted a single center retrospective study of ventilated HM patients between 2014 and 2018. We calculated G-NRI for all patients using their ICU admission albumin and weight. Our primary outcome was ICU mortality. Secondary outcomes included duration of mechanical ventilation and ICU length of stay. Two hundred eighty patients were admitted to the ICU requiring ventilation. Median age was 62 years (IQR 51-68), 42% (n = 118) were females, and median SOFA score was 11 (IQR 9-14). The most common type of HM was acute leukemia (54%) and 40% underwent hematopoietic cell transplant. Median G-NRI was 87 (IQR 79-99). ICU mortality was 51% (n = 143) with a median duration of ventilation of 4 days (IQR 2-7). Mortality across those at severe malnutrition (NRI < 83.5) was 59% (65/111) compared to 46% (76/164) across those with moderate-no risk (p = 0.047). On multivariable analysis, severe NRI (OR 2.34, 95% CI 1.04-5.27, p = 0.04) was significantly associated with ICU mortality. In this single center, exploratory study, severe G-NRI was prognostic of ICU mortality in HM patients admitted with respiratory failure. (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.) |
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فهرسة مساهمة: | Keywords: ARDS; Acute respiratory failure; Frailty; Hematological malignancy; Nutritional risk index |
تواريخ الأحداث: | Date Created: 20221221 Date Completed: 20230202 Latest Revision: 20230202 |
رمز التحديث: | 20231215 |
DOI: | 10.1007/s00277-022-05064-7 |
PMID: | 36542101 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1432-0584 |
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DOI: | 10.1007/s00277-022-05064-7 |