Respiratory failure & ventilation
Epidemiology, ventilation, and outcomes of acute respiratory failure in immunocompromised patients from 103 intensive care units in 26 countries: a retrospective observational study
Authors' conclusion
In this large international cohort of immunocompromised patients with ARF, we identified key risk and protective factors for mortality and intubation.
Study context
- Population
- Adults (≥18 years) with ARF and immunodeficiency admitted to intensive care unit (ICU), 2017–2023
- Participants
- 9,854 adults · 103 ICUs
- Outcome
- 30-day mortality and associated factors
- Follow-up
- 30 days
Methodological detailsmulticentre, international (103 ICUs, 26 countries)
- Multicentre
- International (103 ICUs, 26 countries)
Main finding
As reported in the abstract
30-day mortality
- 30-day mortality rate (4662 patients)
- 47.3%
- Older age, HR
- 1.01 [IQR 1.00-1.02]
- Higher Charlson Comorbidity Index score, HR
- 1.04 [1.01-1.07]
- Higher Frailty Index score, HR
- 1.22 [1.16-1.28]
- Longer time from hospital to ICU admission, HR
- 1.02 [1.01-1.03]
- Higher respiratory rate, HR
- 1.02 [1.02-1.03]
- Coma at ICU admission, HR
- 2.04 [1.72-2.43]
- Invasive fungal infection as cause of ARF, HR
- 1.82 [1.45-2.28]
- Disease-specific infiltrates, HR
- 1.73 [1.32-2.26]
- Unidentified cause of ARF, HR
- 2.16 [1.74-2.68]
- Vasoactive drugs, HR
- 2.45 [2.10-2.86]
- RRT, HR
- 2.07 [1.74-2.48]
- Solid organ transplant (protective), HR
- 0.62 [0.49-0.79]
- Systemic vasculitis or connective tissue disease (protective), HR
- 0.61 (0.47-0.78]
- Higher PaO2/FiO2 ratio (protective), HR
- 0.78 [0.72-0.84]
- HFNO (protective), HR
- 0.78 [0.64-0.95]
- Cardiogenic pulmonary oedema (protective), HR
- 0.67 [0.51-0.89]
Observational data: associations, not effects.
Further findings
Patient characteristics
- Median age, years (IQR 54-71)
- 64
- Female, n (%)
- 3941 (40.0%)
- Haematological malignancy, n (%)
- 4759 [48.3%]
- Solid malignancy, n (%)
- 3818 [38.7%]
- Infection as cause of ARF, n (%)
- 6610 [62.0%]
- More than one cause of ARF, n (%)
- 5288 (53.7%)
- No cause identified, n (%)
- 1490 (15.1%)
- Median PaO2/FiO2 ratio [IQR 141-208]
- 198
Original publication
Epidemiology, ventilation, and outcomes of acute respiratory failure in immunocompromised patients from 103 intensive care units in 26 countries: a retrospective observational study. Lancet Respir Med. Published 16 March 2026. doi:10.
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