The impact of acute brain dysfunction in the outcomes of mechanically ventilated cancer patients

Bibliographic Details
Main Author: Almeida, Isabel C. T.
Publication Date: 2014
Other Authors: Soares, Márcio, Bozza, Fernando Augusto, Shinotsuka, Cassia Righy, Bujokas, Renata, Dantas, Vicente Cés Souza, Ely, E. Wesley, Salluh, Jorge Ibrain Figueira
Format: Article
Language: eng
Source: Repositório Institucional da FIOCRUZ (ARCA)
Download full: https://www.arca.fiocruz.br/handle/icict/10447
Summary: CNPq, FAPERJ
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spelling Almeida, Isabel C. T.Soares, MárcioBozza, Fernando AugustoShinotsuka, Cassia RighyBujokas, RenataDantas, Vicente Cés SouzaEly, E. WesleySalluh, Jorge Ibrain Figueira2015-05-21T16:36:41Z2015-05-21T16:36:41Z2014ALMEIDA, Isabel C. T. et al. The impact of acute brain dysfunction in the outcomes of mechanically ventilated cancer patients. Plos One, v.9, n.1, p.e85332, 2014.1932-6203https://www.arca.fiocruz.br/handle/icict/1044710.1371/journal.pone.00853321932-6203CNPq, FAPERJInstituto Nacional de Câncer. Unidade de Cuidados Intensivos e do Programa de Pós-Graduação. Rio de Janeiro, RJ, BrasilInstituto Nacional de Câncer. Unidade de Cuidados Intensivos e do Programa de Pós-Graduação. Rio de Janeiro, RJ, Brasil / D'Or Instituto de Ensino e Pesquisa. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Medicina Intensiva. Rio de Janeiro, RJ, Brasil / D'Or Instituto de Ensino e Pesquisa. Rio de Janeiro, RJ, BrasilInstituto Nacional de Câncer. Unidade de Cuidados Intensivos e do Programa de Pós-Graduação. Rio de Janeiro, RJ, Brasil / D'Or Instituto de Ensino e Pesquisa. Rio de Janeiro, RJ, BrasilInstituto Nacional de Câncer. Unidade de Cuidados Intensivos e do Programa de Pós-Graduação. Rio de Janeiro, RJ, BrasilInstituto Nacional de Câncer. Unidade de Cuidados Intensivos e do Programa de Pós-Graduação. Rio de Janeiro, RJ, BrasilVanderbilt University School of Medicine. Nashville, TN, United States of America / Veteran’s Affairs Tennessee Valley Geriatric Research Education Clinical Center. Nashville, TN, United States of AmericaInstituto Nacional de Câncer. Unidade de Cuidados Intensivos e do Programa de Pós-Graduação. Rio de Janeiro, RJ, Brasil / D'Or Instituto de Ensino e Pesquisa. Rio de Janeiro, RJ, BrasilIntroduction: Delirium and coma are a frequent source of morbidity for ICU patients. Several factors are associated with the prognosis of mechanically ventilated (MV) cancer patients, but no studies evaluated delirium and coma (acute brain dysfunction). The present study evaluated the frequency and impact of acute brain dysfunction on mortality. Methods: The study was performed at National Cancer Institute, Rio de Janeiro, Brazil. We prospectively enrolled patients ventilated .48 h with a diagnosis of cancer. Acute brain dysfunction was assessed during the first 14 days of ICU using RASS/CAM-ICU. Patients were followed until hospital discharge. Univariate and multivariable analysis were performed to evaluate factors associated with hospital mortality. Results: 170 patients were included. 73% had solid tumors, age 65 [53–72 (median, IQR 25%–75%)] years. SAPS II score was 54[46–63] points and SOFA score was (7 [6–9]) points. Median duration of MV was 13 (6–21) days and ICU stay was 14 (7.5– 22) days. ICU mortality was 54% and hospital mortality was 66%. Acute brain dysfunction was diagnosed in 161 patients (95%). Survivors had more delirium/coma-free days [4(1,5–6) vs 1(0–2), p,0.001]. In multivariable analysis the number of days of delirium/coma-free days were associated with better outcomes as they were independent predictors of lower hospital mortality [0.771 (0.681 to 0.873), p,0.001]. Conclusions: Acute brain dysfunction in MV cancer patients is frequent and independently associated with increased hospital mortality. Future studies should investigate means of preventing or mitigating acute brain dysfunction as they may have a significant impact on clinical outcomes.engPublic Library of ScienceThe impact of acute brain dysfunction in the outcomes of mechanically ventilated cancer patientsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleNeoplasmsRespiration, ArtificialHospital MortalityData Interpretation, StatisticalNeoplasiasRespiração ArtificialMortalidade HospitalarInterpretação Estatística de Dadosinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82352https://www.arca.fiocruz.br/bitstream/icict/10447/1/license.txtafbdf7d7a9bcf771a1cc7edf5f618413MD51ORIGINALThe impact of acute brain dysfunction in the outcomes of mechanically ventilated cancer patients.pdfThe impact of acute brain dysfunction in the outcomes of mechanically ventilated 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dc.title.pt_BR.fl_str_mv The impact of acute brain dysfunction in the outcomes of mechanically ventilated cancer patients
title The impact of acute brain dysfunction in the outcomes of mechanically ventilated cancer patients
spellingShingle The impact of acute brain dysfunction in the outcomes of mechanically ventilated cancer patients
Almeida, Isabel C. T.
Neoplasms
Respiration, Artificial
Hospital Mortality
Data Interpretation, Statistical
Neoplasias
Respiração Artificial
Mortalidade Hospitalar
Interpretação Estatística de Dados
title_short The impact of acute brain dysfunction in the outcomes of mechanically ventilated cancer patients
title_full The impact of acute brain dysfunction in the outcomes of mechanically ventilated cancer patients
title_fullStr The impact of acute brain dysfunction in the outcomes of mechanically ventilated cancer patients
title_full_unstemmed The impact of acute brain dysfunction in the outcomes of mechanically ventilated cancer patients
title_sort The impact of acute brain dysfunction in the outcomes of mechanically ventilated cancer patients
author Almeida, Isabel C. T.
author_facet Almeida, Isabel C. T.
Soares, Márcio
Bozza, Fernando Augusto
Shinotsuka, Cassia Righy
Bujokas, Renata
Dantas, Vicente Cés Souza
Ely, E. Wesley
Salluh, Jorge Ibrain Figueira
author_role author
author2 Soares, Márcio
Bozza, Fernando Augusto
Shinotsuka, Cassia Righy
Bujokas, Renata
Dantas, Vicente Cés Souza
Ely, E. Wesley
Salluh, Jorge Ibrain Figueira
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Almeida, Isabel C. T.
Soares, Márcio
Bozza, Fernando Augusto
Shinotsuka, Cassia Righy
Bujokas, Renata
Dantas, Vicente Cés Souza
Ely, E. Wesley
Salluh, Jorge Ibrain Figueira
dc.subject.en.pt_BR.fl_str_mv Neoplasms
Respiration, Artificial
Hospital Mortality
Data Interpretation, Statistical
topic Neoplasms
Respiration, Artificial
Hospital Mortality
Data Interpretation, Statistical
Neoplasias
Respiração Artificial
Mortalidade Hospitalar
Interpretação Estatística de Dados
dc.subject.decs.pt_BR.fl_str_mv Neoplasias
Respiração Artificial
Mortalidade Hospitalar
Interpretação Estatística de Dados
description CNPq, FAPERJ
publishDate 2014
dc.date.issued.fl_str_mv 2014
dc.date.accessioned.fl_str_mv 2015-05-21T16:36:41Z
dc.date.available.fl_str_mv 2015-05-21T16:36:41Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv ALMEIDA, Isabel C. T. et al. The impact of acute brain dysfunction in the outcomes of mechanically ventilated cancer patients. Plos One, v.9, n.1, p.e85332, 2014.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/10447
dc.identifier.issn.none.fl_str_mv 1932-6203
dc.identifier.doi.none.fl_str_mv 10.1371/journal.pone.0085332
dc.identifier.eissn.none.fl_str_mv 1932-6203
identifier_str_mv ALMEIDA, Isabel C. T. et al. The impact of acute brain dysfunction in the outcomes of mechanically ventilated cancer patients. Plos One, v.9, n.1, p.e85332, 2014.
1932-6203
10.1371/journal.pone.0085332
url https://www.arca.fiocruz.br/handle/icict/10447
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Public Library of Science
publisher.none.fl_str_mv Public Library of Science
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/10447/1/license.txt
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