D Díaz-Díaz1, M Villanova Martínez2, E Palencia Herrejón2. 1. Servicio de Medicina Intensiva, Hospital Universitario Infanta Leonor, Madrid, España. Electronic address: domingodiazdiaz@gmail.com. 2. Servicio de Medicina Intensiva, Hospital Universitario Infanta Leonor, Madrid, España.
Abstract
OBJECTIVE: To analyze the factors influencing in-hospital mortality among cancer patients admitted to an Intensive Care Unit (ICU). DESIGN: A retrospective observational study was carried out. SETTING: The ICU of a community hospital. PATIENTS: Adults diagnosed with solid or hematological malignancies admitted to the ICU, excluding those admitted after scheduled surgery and those with an ICU stay of under 24h. INTERVENTIONS: Review of clinical data. VARIABLES OF INTEREST: Referring ward and length of stay prior to admission to the ICU, type of tumor, extent, Eastern Cooperative Oncology Group (ECOG) score, reason for ICU admission, severity (SOFA, APACHE-II, SAPS-II), type of therapy received in the ICU, and in-hospital mortality. RESULTS: A total of 167 patients (mean age 71.1 years, 62.9% males; 79% solid tumors) were included, of which 61 (36%) died during their hospital stay (35 in the ICU). The factors associated to increased in-hospital mortality were ECOG scores 3-4 (OR 7.23, 95%CI: 1.95-26.87), metastatic disease (OR 3.77, 95%CI: 1.70-8.36), acute kidney injury (OR 3.66, 95%CI: 1.49-8.95) and SOFA score at ICU admission (OR 1.26, 95%CI: 1.10-1.43). A total of 60.3% of the survivors were independent at hospital discharge. CONCLUSIONS: In our series, only one-third of the critically ill cancer patients admitted to the ICU died during hospital admission, and more than 50% showed good performance status at hospital discharge. The clinical prognostic factors associated to in-hospital mortality were poor performance status, metastatic disease, SOFA score at ICU admission and acute kidney injury.
OBJECTIVE: To analyze the factors influencing in-hospital mortality among cancerpatients admitted to an Intensive Care Unit (ICU). DESIGN: A retrospective observational study was carried out. SETTING: The ICU of a community hospital. PATIENTS: Adults diagnosed with solid or hematological malignancies admitted to the ICU, excluding those admitted after scheduled surgery and those with an ICU stay of under 24h. INTERVENTIONS: Review of clinical data. VARIABLES OF INTEREST: Referring ward and length of stay prior to admission to the ICU, type of tumor, extent, Eastern Cooperative Oncology Group (ECOG) score, reason for ICU admission, severity (SOFA, APACHE-II, SAPS-II), type of therapy received in the ICU, and in-hospital mortality. RESULTS: A total of 167 patients (mean age 71.1 years, 62.9% males; 79% solid tumors) were included, of which 61 (36%) died during their hospital stay (35 in the ICU). The factors associated to increased in-hospital mortality were ECOG scores 3-4 (OR 7.23, 95%CI: 1.95-26.87), metastatic disease (OR 3.77, 95%CI: 1.70-8.36), acute kidney injury (OR 3.66, 95%CI: 1.49-8.95) and SOFA score at ICU admission (OR 1.26, 95%CI: 1.10-1.43). A total of 60.3% of the survivors were independent at hospital discharge. CONCLUSIONS: In our series, only one-third of the critically ill cancerpatients admitted to the ICU died during hospital admission, and more than 50% showed good performance status at hospital discharge. The clinical prognostic factors associated to in-hospital mortality were poor performance status, metastatic disease, SOFA score at ICU admission and acute kidney injury.
Authors: Suhail S Siddiqui; Amit M Narkhede; Harish K Chaudhari; Natesh Prabu Ravisankar; Ujwal Dhundi; Satish Sarode; Jigeeshu V Divatia; Atul P Kulkarni Journal: Indian J Crit Care Med Date: 2021-12
Authors: Lama H Nazer; Maria A Lopez-Olivo; Anne Rain Brown; John A Cuenca; Michael Sirimaturos; Khader Habash; Nada AlQadheeb; Heather May; Victoria Milano; Amy Taylor; Joseph L Nates Journal: Crit Care Explor Date: 2022-09-13
Authors: Cristina Gutierrez; Anne Rain T Brown; Heather P May; Amer Beitinjaneh; R Scott Stephens; Prabalini Rajendram; Joseph L Nates; Stephen M Pastores; Ananda Dharshan; Alice Gallo de Moraes; Matthew K Hensley; Lei Feng; Jennifer N Brudno; Janhavi Athale; Monalisa Ghosh; James N Kochenderfer; Alejandro S Arias; Yi Lin; Colleen McEvoy; Elena Mead; Jason Westin; Natalie Kostelecky; Agrima Mian; Megan M Herr Journal: Crit Care Med Date: 2022-01-01 Impact factor: 7.598