Cancer May Be an Independent Risk Factor for ARDS in Critically Ill Patients

Cancer may be an independent risk factor for acute respiratory distress syndrome (ARDS) in critically ill patients admitted to the intensive care unit (ICU), according to the results of a retrospective cohort study presented at the American Thoracic Society (ATS) 2021 International Conference, held virtually from May 14 to 19, 2021.

While previous research has shown cancer can induce systemic inflammation, few research studies have established whether cancer represents an independent risk factor for ARDS. Researchers retrospectively evaluated critically ill patients who were admitted to an ICU at an academic medical center in Ohio between 2017 and 2018. The investigators assessed the association between malignancy and ARDS diagnosis in a multivariable logistic regression analysis.

A total of 412 cases of ARDS were identified during the 16-month study period. Of these ARDS cases, 166 had active cancer. There was a significant association between cancer and the development of ARDS (odds ratio [OR], 1.55; 95% CI, 1.26-1.92; P <.001). In an analysis adjusted for the prespecified confounding variables, the association between cancer and ARDS remained significant (OR, 1.57; 95% CI, 1.15-2.13; P =.004).

An unadjusted prespecified subgroup analysis found a positive association between hematologic malignancy and increased odds of ARDS (OR, 1.81; 95% CI, 1.30-2.53; P <.001). In contrast, there was a negative association between ARDS and nonmetastatic solid tumors (OR, 0.51; 95% CI, 0.31-0.85; P =.01).

Patients with cancer who developed ARDS exhibited a significantly higher rate of ICU mortality (70.5% vs 39.8%; P <.001) and hospital mortality (72.9% vs 40.7%; P <.001) compared with patients with ARDS but without an active malignancy. According to the researchers, this is the first report to confirm an independent association between cancer and ARDS in critically ill patients.

Reference

Ho K, Gordon J, Litzenberg KT, Exline MC, Englert JA, Herman D. Cancer is an independent risk factor for acute respiratory distress syndrome in critically ill patients: a single center retrospective cohort study. Presented at: the American Thoracic Society (ATS) International Conference 2021; May 14-19, 2021. Abstract #A2675.