Michaël Darmon1,2,3, Aurélie Bourmaud4,5,6, Quentin Georges7, Marcio Soares8, Kyeongman Jeon9, Sandra Oeyen10, Chin Kook Rhee11, Pascale Gruber12, Marlies Ostermann13, Quentin A Hill14, Pieter Depuydt10, Christelle Ferra15, Anne-Claire Toffart16, Peter Schellongowski17, Alice Müller18, Virginie Lemiale19, Djamel Mokart20, Elie Azoulay19,4,21. 1. Medical ICU, Saint-Louis University Hospital, AP-HP, Paris, France. michael.darmon@aphp.fr. 2. Faculté de Médecine, Université Paris-Diderot, Sorbonne-Paris-Cité, Paris, France. michael.darmon@aphp.fr. 3. ECSTRA Team, Biostatistics and Clinical Epidemiology, UMR 1153 (Center of Epidemiology and Biostatistic Sorbonne Paris Cité, CRESS), INSERM, Paris, France. michael.darmon@aphp.fr. 4. Faculté de Médecine, Université Paris-Diderot, Sorbonne-Paris-Cité, Paris, France. 5. Public Health Department, Robert Debré University Hospital, AP-HP, Paris, France. 6. UMRS 1123, Clinical Epidemiology and Economic Evaluation Applied to Vulnerable Populations (Epidémiologie Clinique et Évaluation Économique appliquée aux Populations Vulnérables [ECEVE]), Paris Diderot University, Paris, France. 7. Medical-Surgical ICU, Saint-Etienne University Hospital, Saint-Étienne, France. 8. Department of Critical Care and Graduate Program in Translational Medicine, D'Or Institute for Research and Education, Rio de Janeiro, Brazil. 9. Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. 10. Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium. 11. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, The Catholic University of Korea, Seoul, South Korea. 12. Department of Critical Care, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK. 13. Department of Critical Care and Nephrology, King's College London, Guy's and St Thomas' NHS Foundation Hospital, London, UK. 14. Department of Haematology, Leeds Teaching Hospitals, Leeds, UK. 15. Department of Clinical Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain. 16. Thoracic Oncology Unit, Grenoble Alpes University Hospital, Grenoble, France. 17. Department of Medicine I, Intensive Care Unit 13i2, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. 18. Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Porto Alegre, Brazil. 19. Medical ICU, Saint-Louis University Hospital, AP-HP, Paris, France. 20. Anesthesiology and Intensive Care Unit, Institut Paoli Calmette, Marseille, France. 21. ECSTRA Team, Biostatistics and Clinical Epidemiology, UMR 1153 (Center of Epidemiology and Biostatistic Sorbonne Paris Cité, CRESS), INSERM, Paris, France.
Abstract
PURPOSE: The number of averted deaths due to therapeutic advances in oncology and hematology is substantial and increasing. Survival of critically ill cancer patients has also improved during the last 2 decades. However, these data stem predominantly from unadjusted analyses. The aim of this study was to assess the impact of ICU admission year on short-term survival of critically ill cancer patients, with special attention on those with neutropenia. METHODS: Systematic review and meta-analysis of individual data according to the guidelines of meta-analysis of observational studies in epidemiology. DATASOURCE: Pubmed and Cochrane databases. ELIGIBILITY CRITERIA: Adult studies published in English between May 2005 and May 2015. RESULTS: Overall, 7354 patients were included among whom 1666 presented with neutropenia at ICU admission. Median ICU admission year was 2007 (IQR 2004-2010; range 1994-2012) and median number of admissions per year was 693 (IQR 450-1007). Overall mortality was 47.7%. ICU admission year was associated with a progressive decrease in hospital mortality (OR per year 0.94; 95% CI 0.93-0.95). After adjustment for confounders, year of ICU admission was independently associated with hospital mortality (OR for hospital mortality per year: 0.96; 95% CI 0.95-0.97). The association was also seen in patients with neutropenia but not in allogeneic stem cell transplant recipients. CONCLUSION: After adjustment for patient characteristics, severity of illness and clustering, hospital mortality decreased steadily over time in critically ill oncology and hematology patients except for allogeneic stem cell transplant recipients.
PURPOSE: The number of averted deaths due to therapeutic advances in oncology and hematology is substantial and increasing. Survival of critically ill cancerpatients has also improved during the last 2 decades. However, these data stem predominantly from unadjusted analyses. The aim of this study was to assess the impact of ICU admission year on short-term survival of critically ill cancerpatients, with special attention on those with neutropenia. METHODS: Systematic review and meta-analysis of individual data according to the guidelines of meta-analysis of observational studies in epidemiology. DATASOURCE: Pubmed and Cochrane databases. ELIGIBILITY CRITERIA: Adult studies published in English between May 2005 and May 2015. RESULTS: Overall, 7354 patients were included among whom 1666 presented with neutropenia at ICU admission. Median ICU admission year was 2007 (IQR 2004-2010; range 1994-2012) and median number of admissions per year was 693 (IQR 450-1007). Overall mortality was 47.7%. ICU admission year was associated with a progressive decrease in hospital mortality (OR per year 0.94; 95% CI 0.93-0.95). After adjustment for confounders, year of ICU admission was independently associated with hospital mortality (OR for hospital mortality per year: 0.96; 95% CI 0.95-0.97). The association was also seen in patients with neutropenia but not in allogeneic stem cell transplant recipients. CONCLUSION: After adjustment for patient characteristics, severity of illness and clustering, hospital mortality decreased steadily over time in critically ill oncology and hematology patients except for allogeneic stem cell transplant recipients.
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Authors: David R Price; Katherine L Hoffman; Clara Oromendia; Lisa K Torres; Edward J Schenck; Mary E Choi; Augustine M K Choi; Rebecca M Baron; Jin-Won Huh; Ilias I Siempos Journal: Am J Respir Crit Care Med Date: 2021-02-15 Impact factor: 21.405
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