Edith Borcoman1, Axelle Dupont2, Eric Mariotte1, Ludovic Doucet3, Adrien Joseph1, Akli Chermak1, Sandrine Valade1, Matthieu Resche-Rigon2, Elie Azoulay4, Virginie Lemiale5. 1. Medical ICU, APHP Hopital Saint Louis, 1 avenue Claude Vellefaux, 75010 Paris, France. 2. Biostatistic department, APHP Hopital Saint Louis, 1 avenue Claude Vellefaux, 75010 Paris, France. 3. Oncologic department, APHP Hopital Saint Louis, 1 avenue Claude Vellefaux, 75010 Paris, France. 4. Medical ICU, APHP Hopital Saint Louis, 1 avenue Claude Vellefaux, 75010 Paris, France; Biostatistic department, APHP Hopital Saint Louis, 1 avenue Claude Vellefaux, 75010 Paris, France. 5. Medical ICU, APHP Hopital Saint Louis, 1 avenue Claude Vellefaux, 75010 Paris, France. Electronic address: virginie.lemiale@sls.aphp.fr.
Abstract
PURPOSE: Outcomes in cancer patients after unplanned ICU admission was reassessed. METHODS: retrospective cohort of patients with solid tumours admitted to ICU over a 10 years period. RESULTS: 622 patients (age 62 [53-70]) were analysed. The most common primary sites of cancer were lung (n = 133; 21.4%) and digestive tract (n = 126; 20.2%) The ICU mortality rate was 22.2% (n = 138). Among 470 ICU survivors, the 1-year mortality was 41.3% (95% CI, 36-45.9) (n = 167). Factors independently associated with 1-year mortality were ICU admission after 2010 (HR 0.53 (0.37-0.76), p < .001), disease status (respectively, HR = 1.88 (1.0.2-3.45), p = .002) for locally advanced cancer and HR = 2.23 (1.35-3.67), p = .003) for metastatic cancer), poor performance status (HR = 1.58 (1.08-2.31), p = .019), newly diagnosed cancer at ICU admission (HR = 2.02 (1.28-3.20), p = .003), inability to receive oncologic treatment after ICU discharge (HR = 5.34 (3.49-8.18), p < .001) and decision to withhold life-sustaining treatment during ICU stay (HR = 2.34 (1.50-3.65), p < .001). CONCLUSIONS: Among the factors associated with one-year mortality after ICU discharge, the possibility of receiving oncologic treatment after ICU discharge seems crucial.
PURPOSE: Outcomes in cancerpatients after unplanned ICU admission was reassessed. METHODS: retrospective cohort of patients with solid tumours admitted to ICU over a 10 years period. RESULTS: 622 patients (age 62 [53-70]) were analysed. The most common primary sites of cancer were lung (n = 133; 21.4%) and digestive tract (n = 126; 20.2%) The ICU mortality rate was 22.2% (n = 138). Among 470 ICU survivors, the 1-year mortality was 41.3% (95% CI, 36-45.9) (n = 167). Factors independently associated with 1-year mortality were ICU admission after 2010 (HR 0.53 (0.37-0.76), p < .001), disease status (respectively, HR = 1.88 (1.0.2-3.45), p = .002) for locally advanced cancer and HR = 2.23 (1.35-3.67), p = .003) for metastatic cancer), poor performance status (HR = 1.58 (1.08-2.31), p = .019), newly diagnosed cancer at ICU admission (HR = 2.02 (1.28-3.20), p = .003), inability to receive oncologic treatment after ICU discharge (HR = 5.34 (3.49-8.18), p < .001) and decision to withhold life-sustaining treatment during ICU stay (HR = 2.34 (1.50-3.65), p < .001). CONCLUSIONS: Among the factors associated with one-year mortality after ICU discharge, the possibility of receiving oncologic treatment after ICU discharge seems crucial.
Authors: Esther N van der Zee; Fabian Termorshuizen; Dominique D Benoit; Nicolette F de Keizer; Jan Bakker; Erwin J O Kompanje; Wim J R Rietdijk; Jelle L Epker Journal: J Intensive Care Med Date: 2021-11-17 Impact factor: 2.889