Table 3. Characteristics of patients treated with HFNC: Comparison of HFNC success with HFNC failure requiring intubation.
| All patients (n = 202) | No intubation (n = 104) | Intubation requirement (n = 98) | sHR [95% CI] | p | |
|---|---|---|---|---|---|
| Female gender | 123 (60.9%) | 60 (57.7%) | 63 (64.3%) | 1.22 [0.81–1.84] | 0.35 |
| Age (years) | 63 [53.2–69] | 63 [53–69] | 62.5 [54–68.7] | 1 [0.9–1.02] | 0.97 |
| Charlson comorbidity index | 4 [3–6] | 4.5 [3–7] | 4 [3–6] | 0.94 [0.86–1.03] | 0.19 |
| BMI | 23.9 [21.3–26.6] | 24.2 [21.2–28.2] | 23.6 [21.4–25.8] | 0.98 [0.94–1.02] | 0.31 |
| Main underlying malignancy | |||||
| Others malignancies | 23 (11.4%) | 10 (9.6%) | 13 (13.3%) | 1 (reference) | 0.367 |
| Acute leukemias | 66 (32.7%) | 33 (31.7%) | 33 (33.7%) | 0.91 [0.48–1.73] | |
| Lymphomas | 35 (17.3%) | 14 (13.5%) | 21 (21.4%) | 1.14 [0.57–2.28] | |
| CLL/CML | 10 (4.9%) | 5 (4.8%) | 5 (5.1%) | 0.91 [0.32–2.55] | |
| Solid tumors | 68 (33.7%) | 42 (40.4%) | 26 (26.5%) | 0.65 [0.33–1.26] | |
| Allo-HSCT | 35 (17.3%) | 12 (11.5%) | 23 (23.5%) | 1.51 [0.95–2.41] | 0.09 |
| Disease status | |||||
| Newly diagnosed | 82 (40.6%) | 43 (41.3%) | 39 (39.8%) | 1 (reference) | 0.72 |
| Progression/Relapse | 86 (42.6%) | 42 (40.4%) | 44 (44.9%) | 1.01 [0.66–1.56] | |
| Complete/partial response | 34 (16.8%) | 19 (18.3%) | 15 (15.3%) | 0.81 [0.44–1.46] | |
| Documented sepsis | |||||
| Bacterial | 80 (39.6%) | 44 (42.3%) | 36 (36.7%) | 0.83 [0.55–1.25] | 0.37 |
| Including MDR bacteria | 25 (12.4%) | 8 (7.7%) | 17 (17.3%) | 1.65 [0.98–2.78] | 0.08 |
| Viral | 38 (18.8%) | 10 (9.64%) | 28 (28.6%) | 2 [1.29–3.1] | 0.003 |
| Fungal | 30 (14.9%) | 10 (9.6%) | 20 (20.4%) | 1.66 [1.01–2.7] | 0.05 |
| Fever of unknown origin | 32 (15.8%) | 17 (16.3%) | 15 (15.3%) | 1.03 [0.6–1.79] | 0.91 |
| Absence of sepsis | 25 (12.4%) | 20 (19.2%) | 5 (5.1%) | 0.31 [0.12–0.75] | 0.002 |
| Neutropenia at ICU admission | 48 (23.9%) | 23 (22.1%) | 25 (25.8) | 1.17 [0.74–1.85] | 0.5 |
| Severity at ICU admission | |||||
| SOFA score | 5 [2–7] | 4 [2–6] | 5 [2.2–7] | 1.07 [1.01–1.14] | 0.03 |
| SAPS II | 42 [34–49] | 40 [31–47.2] | 43 [37–50] | 1.03 [1.01–1.04] | <0.001 |
| At HFNC initiation | |||||
| SOFA score | 5 [2–7] | 5 [2–6] | 5 [3–8] | 1.1 [1.04–1.16] | 0.003 |
| Nb of quadrants on X-rays | 2 [1–4] | 2 [1–3] | 3 [2–4] | 1.57 [1.33–1.85] | <0.001 |
| Sp02 (%) | 94 [92–97] | 95 [93–98] | 94 [91–96] | 0.94 [0.9–0.98] | 0.009 |
| Fi02 (%) | 60 [50–80] | 55 [50–70] | 70 [50–100] | 1.02 [1.01–1.03] | <0.001 |
| Fi02 >60% | 92 (45.5%) | 34 (32.7%) | 58 (59.2%) | 2.28 [1.52–3.41] | <0.001 |
| Sp02 < 95% | 102 (50.5%) | 50 (48.1%) | 52 (53.1%) | 1.19 [1.1–2.58] | 0.39 |
| Oxygen flow (L/min) | 40 [40–50] | 40 [30–50] | 50 [40–50] | 1.04 [1.01–1.06] | 0.003 |
| Respiratory Rate (/min) | 27 [20–32] | 26 [19–30] | 28 [21–34] | 1.02 [1–1.05] | 0.0475 |
| Heart rate | 110 [96–123] | 109 [96–121] | 111 [96–124] | 1.01 [1–1.02] | 0.136 |
| Time since ICU admission (days) | 0 [0–1] | 0 [0–1] | [0–0] | 1.00 [0.89–1.12] | 0.98 |
| Respiratory SOFA: Pa02/Fi02 | |||||
| >400 | 1 (0.5%) | 0 | 1 (1%) | 1 (reference) | 0.24 |
| 301–400 | 21 (10.4%) | 13 (12.5%) | 8 (8.2%) | 0.14 [0.02–1.11] | |
| ≤300 | 180 (89.1%) | 91 (87.5%) | 89 (90.8%) | 0.20 [0.03–1.46] | |
| After HFNC initiation | |||||
| RR after 15 minutes | 21 [16–29] | 20 [15–26] | 25 [17–33] | 1.04 [1.02–1.06] | <0.001 |
| Sp02 after 15 minutes | 96 [94–98] | 97 [95–98] | 96 [93–98] | 0.97 [0.95–0.99] | 0.03 |
| Sp02<95% with FiO2 = 100% after 15 minutes | 80 (39.6%) | 34 (32.7%) | 46 (46.9%) | 1.68 [1.1–2.58] | 0.02 |
AlloHSCT: allogenic hematopoietic stem cell transplantation, BMI: body mass index, CLL: chronic lymphocytic leukemia, CML: chronic myeloid leukemia, Fi02: fraction of inspired oxygen, HFNC: high flow nasal cannula, ICU: intensive care unit, MDR: multi-drug resistant, RR: respiratory rate, SAPS II: simplified acute physiology score II, SOFA: sequential organ failure assessment, Sp02: oxygen saturation, sHR: subdistribution Hazard Ratio