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Table 3 Characteristics and comparison of patients grouped by failure (n = 104)

From: Use of high flow nasal cannula in patients with acute respiratory failure in general wards under intensivists supervision: a single center observational study

 

Success

(n = 84)

Failure

(n = 20)#

p value

OR (95% CI)

Age—year

76 [61–81]

75 [68–88]

0.15

1.02 (0.99–1.06)

Male sex—no. (%)

45 (54%)

7 (35%)

0.13

0.47 (0.17–1.28)

SOFA Score

3 [2–4]

4 [2–5]

0.21

1.18 (0.91–1.53)

APACHE Score

10 [7–14]

11 [10–15]

0.003

1.59 (1.09–4.17)

Charlson’s Comorbidity Index

4 [3–6]

6 [5–8]

0.004

1.29 (1.07–1.55)

Comorbidities—no. (%)*

 COPD

29 (35%)

9 (45%)

0.39

1.55 (0.58–4.17)

 Others respiratory

22 (26%)

3 (15%)

0.27

0.50 (0.13–1.86)

 Malignancies

15 (18%)

6 (30%)

0.24

1.97 (0.65–5.97)

 Congestive heart failure

10 (12%)

3 (15%)

0.71

1.31 (0.32–5.26)

 Cardiac

14 (17%)

5 (25%)

0.40

1.67 (0.52–5.33)

 Hypertension

32 (38%)

4 (20%)

0.11

0.41 (0.12–1.32)

 Hepatic

4 (5%)

1 (5%)

0.96

1.05 (0.11–9.96)

 Renal

7 (8%)

1 (5%)

0.60

0.58 (0.07–4.99)

 Diabetes mellitus

7 (8%)

2 (10%)

0.81

1.22 (0.23–6.38)

 Neurologic

8 (10%)

2 (10%)

0.95

1.05 (0.21–5.40)

Immunocompromised—no. (%)§

20 (24%)

6 (30%)

0.57

1.37 (0.46–4.04)

Reason for hospital admission—no. (%)

 Respiratory

63 (75%)

12 (60%)

0.19

0.5 (0.18–1.39)

 Surgery

5 (6%)

1 (5%)

0.87

0.83 (0.09–7.54)

 Extrapulmonary sepsis

3 (4%)

2 (10%)

0.27

3 (0.47–19.28)

 Cardiac

3 (4%)

2 (10%)

0.27

3 (0.47–19.28)

 Mixed cardiac—respiratory

1 (1%)

0 (0%)

0.51

[–]

 Others

9 (10%)

3 (15%)

0.60

1.47 (0.36–6.02)

Cause of acute respiratory failure—no. (%)

 Community-acquired pneumonia

43 (51%)

9 (45%)

0.62

0.78 (0.29–2.08)

 Hospital-acquired pneumonia

13 (16%)

3 (15%)

0.96

0.96 (0.25–3.76)

 COPD

11 (13%)

2 (10%)

0.70

0.73 (0.15–3.62)

 Others respiratory

6 (7%)

1 (5%)

0.72

0.68 (0.08–6.03)

 Cardiac failure

5 (6%)

5 (25%)

0.02

5.26 (1.36–20.46)

 Mixed cardiac—respiratory

6 (7%)

0 (0%)

0.10

[–]

Bilateral infiltrates in chest radiograph—no. (%)

29 (35%)

11 (55%)

0.09

2.32 (0.86–6.23)

Death—no (%)

6 (7%)

10 (50%)$

 < 0.001

13 (3.89–43.48)

  1. FiO2 inspired fraction of O2; PaO2 arterial partial pressure of O2; ROX Index ratio of SpO2/FiO2 to respiratory rate
  2. *Overlap may exist between comorbidities
  3. §Immunocompromised: use of long-term (> 3 months) or high-dose (> 0.5 mg/kg/day) steroids, use of other immunosuppressant drugs, solid organ transplantation, solid cancer requiring chemotherapy in the last 5 years, hematologic malignancy regardless of time since diagnosis and received treatments, or primary immune deficiency
  4. #Of the 20 patients who failed, 3 did not tolerate the device, 14 need escalation of the ventilatory support in the ward and only 3 were transferred to ICU. 2 patients out of the 3 admitted to ICU died for ARF worsening. Hence, the rate of failure is 20/104 (19.2%)
  5. $Of the 10 patients who died, 8 had a do-not-intubate order and only 2 had been assigned a “full code resuscitation”