Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, MN.
Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Mayo Clin Proc. 2024 Apr;99(4):578-592. doi: 10.1016/j.mayocp.2023.07.024. Epub 2024 Mar 7.
To determine the epidemiological effect-magnitude and outcomes of patients with cancer vs those without cancer who are hospitalized with acute respiratory failure (ARF).
We reviewed hospitalizations within the National Inpatient Sample (NIS) database between January 1, 2016, and December 31, 2018. Patients were classified based on a diagnosis of solid-organ cancer, hematologic cancer, or no cancer. Noninvasive positive pressure ventilation (NIPPV) failure was defined as patients who initially received NIPPV and had progression to invasive mechanical ventilation. Weighted samples were used to derive population estimates.
During the study period, there were an estimated 8,837,209 admissions with ARF in the United States, 8.9% (783,625) of which had solid-organ cancer and 2.0% (176,095) had hematologic cancers. Annually, 319,907 patients with cancer are admitted with ARF, with 27.3% (87,302) requiring invasive mechanical ventilation and 10.0% (31,998) requiring NIPPV. In-hospital mortality was higher in patients with cancer vs those without cancer (24.0% [76,813] vs 12.3% [322,465]; P<.001), and this proprotion persisted when stratified by the highest method of oxygen delivery. Patients with cancer had longer hospital length of stay (7.0 days [3.0 to 12.0 days] vs 5.0 days [3.0 to 10.0 days]; P<.001) and were more likely to have NIPPV failure (14.9% [3,992] vs 12.8% [41,875]). Compared with those with solid-organ cancer, patients with hematologic cancers experienced worse outcomes. The association between underlying cancer diagnosis and outcomes remained consistent when adjusted for age, sex, and comorbidities.
In the United States, patients with cancer account for over 10% of ARF hospital admissions (959,720 of 8,837,209). They experience an approximately 2-fold higher mortality versus those without cancer. Those with hematologic cancers appear to experience worse outcomes than patients with solid-organ cancers.
确定因急性呼吸衰竭（ARF）住院的癌症患者与非癌症患者的流行病学影响程度和结局。
我们回顾了 2016 年 1 月 1 日至 2018 年 12 月 31 日期间国家住院患者样本（NIS）数据库中的住院情况。患者根据实体器官癌、血液癌或无癌症的诊断进行分类。非侵入性正压通气（NIPPV）失败定义为最初接受 NIPPV 并进展为有创机械通气的患者。使用加权样本得出人口估计值。
在研究期间，美国估计有 8837209 例 ARF 入院，其中 8.9%（783625 例）有实体器官癌，2.0%（176095 例）有血液癌。每年有 319907 例癌症患者因 ARF 入院，其中 27.3%（87302 例）需要有创机械通气，10.0%（31998 例）需要 NIPPV。癌症患者的院内死亡率高于无癌症患者（24.0%[76813 例] vs 12.3%[322465 例]；P<.001），当按最高供氧方式分层时，这一比例仍然存在。癌症患者的住院时间更长（7.0 天[3.0 至 12.0 天] vs 5.0 天[3.0 至 10.0 天]；P<.001），并且更有可能发生 NIPPV 失败（14.9%[3992 例] vs 12.8%[41875 例]）。与实体器官癌患者相比，血液癌患者的预后更差。在调整年龄、性别和合并症后，基础癌症诊断与结局之间的关联仍然一致。
在美国，癌症患者占 ARF 住院患者的 10%以上（8837209 例中的 959720 例）。与非癌症患者相比，他们的死亡率约高出 2 倍。血液癌患者的预后似乎比实体器官癌患者更差。
