title: The outcome of cancer patients with acute respiratory distress syndrome.
abstract: OBJECTIVE
  The objective of the study is to determine the 28-day mortality of critically ill cancer patients with acute respiratory distress syndrome (ARDS).
  
  
  METHODS
  This is a retrospective cohort study of patients enrolled in the ARDS Network randomized controlled trials.
  
  
  RESULTS
  A total of 2515 patients did not have cancer, and 116 patients had cancer. Patients with cancer were older (median, 61 vs 49 years; P < .0001), more critically ill (the median Acute Physiology and Chronic Health Evaluation III score without cancer comorbidity was 105 for the cancer group compared with 87 for those without cancer; P < 0.0001), and more likely to have pneumonia or sepsis as cause of acute lung injury (79.31% vs 62.70%; P = .0011). The overall mortality at day 28 was 25.7%. Patients with cancer had significantly higher mortality (55.2%) compared with those without cancer (24.3%) (P < .0001). The odds ratio for mortality from ARDS at 28 days for cancer patients was 2.54 (95% confidence interval [CI], 1.570-4.120). Acute Physiology and Chronic Health Evaluation III score and age were found to be significant predictors of outcome in cancer patients with odds ratio of 1.034 (95% CI, 1.007-1.062; P = .0135) and 1.075 (95% CI, 1.024-1.129, P = .0036), respectively.
  
  
  CONCLUSIONS
  Cancer patients with ARDS have a significantly higher risk of death compared with those without cancer. The increased risk appeared to be mediated by increased severity of illness at presentation, as well as by age.
authors: Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University School of Medicine, Detroit, MI. Electronic address: asoubani@med.wayne.edu.
authors: Ayman O
authors: AO
authors: Soubani
authors: Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University School of Medicine, Detroit, MI.
authors: Emad
authors: E
authors: Shehada
authors: Department of Oncology, Karmanos Cancer Center and Wayne State University School of Medicine, Detroit, MI.
authors: Wei
authors: W
authors: Chen
authors: Department of Oncology, Karmanos Cancer Center and Wayne State University School of Medicine, Detroit, MI.
authors: Daryn
authors: D
authors: Smith
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000401:mortality*; D016032:Randomized Controlled Trials as Topic; D012128:Respiratory Distress Syndrome / Q000453:epidemiology*; D012189:Retrospective Studies; D055815:Young Adult
keywords: ARDS; Cancer; Outcome