Desfecho de pacientes com câncer de pulmão admitidos em unidades de terapia intensiva

Müller, Alice Mânica; Gazzana, Marcelo Basso; Silva, Denise Rossato

doi:10.1590/s0103-507x2013000100004

Cited by 21 publications

(15 citation statements)

References 17 publications

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“…The variable of outcome was hospital mortality in 27 studies and 28-day mortality in three studies. Overall, the number of patients included per study was 166 (IQR 99–266) and ranged from 34 [ 38 ] to 1090 [ 35 ].…”

Section: Resultsmentioning

confidence: 99%

Influence of neutropenia on mortality of critically ill cancer patients: results of a meta-analysis on individual data

et al. 2018

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BackgroundThe study objective was to assess the influence of neutropenia on outcome of critically ill cancer patients by meta-analysis of individual data. Secondary objectives were to assess the influence of neutropenia on outcome of critically ill patients in prespecified subgroups (according to underlying tumor, period of admission, need for mechanical ventilation and use of granulocyte colony stimulating factor (G-CSF)).MethodsData sources were PubMed and the Cochrane database. Study selection included articles focusing on critically ill cancer patients published in English and studies in humans from May 2005 to May 2015. For study selection, the study eligibility was assessed by two investigators. Individual data from selected studies were obtained from corresponding authors.ResultsOverall, 114 studies were identified and authors of 30 studies (26.3% of selected studies) agreed to participate in this study. Of the 7515 included patients, three were excluded due to a missing major variable (neutropenia or mortality) leading to analysis of 7512 patients, including 1702 neutropenic patients (22.6%). After adjustment for confounders, and taking study effect into account, neutropenia was independently associated with mortality (OR 1.41; 95% CI 1.23–1.62; P = 0.03). When analyzed separately, neither admission period, underlying malignancy nor need for mechanical ventilation modified the prognostic influence of neutropenia on outcome. However, among patients for whom data on G-CSF administration were available (n = 1949; 25.9%), neutropenia was no longer associated with outcome in patients receiving G-CSF (OR 1.03; 95% CI 0.70–1.51; P = 0.90).ConclusionAmong 7512 critically ill cancer patients included in this systematic review, neutropenia was independently associated with poor outcome despite a meaningful survival. Neutropenia was no longer significantly associated with outcome in patients treated by G-CSF, which may suggest a beneficial effect of G-CSF in neutropenic critically ill cancer patients.Systematic review registrationPROSPERO CRD42015026347. Date of registration: Sept 18 2015Electronic supplementary materialThe online version of this article (10.1186/s13054-018-2076-z) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Influence of neutropenia on mortality of critically ill cancer patients: results of a meta-analysis on individual data

et al. 2018

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“…Although critical care advances have improved the survival of these critically ill patients, not all lung cancer patients have derived benefit from intensive care 7 . Several retrospective studies identified factors associated with the poor ICU outcomes for these patients, including requiring mechanical ventilation 3 , 4 , 6 , 8 - 10 , poor pre-event performance status (PS) 2 , 6 , 11 , high admission Acute Physiologic and Chronic Health Evaluation (APACHE) III scores with vasopressor use 8 , and refractory disease 4 , 6 , 8 , 12 . Nevertheless, treatment outcomes and mortality predictors remain unclear for treatment-naïve lung cancer patients requiring intensive care.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of cancer therapy administered to treatment-naïve lung cancer patients in the intensive care unit

Chen

Lin

et al. 2017

J. Cancer

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Objectives: Therapy outcomes for newly diagnosed, critically ill lung cancer patients have seldom been evaluated. This study evaluated therapy outcomes for treatment-naïve lung cancer patients in the intensive care unit (ICU). Materials and Methods: Patients were excluded if they had previously received lung cancer treatment, such as systemic chemotherapy, targeted therapy, radiotherapy, or surgical lung resection before ICU admission. The therapeutic strategies for the treatment-naïve patients were determined while they were in the ICU. The patients' demographic data, clinical outcomes, and treatment-related toxicities were analyzed. Results: Newly diagnosed lung cancer patients (n = 72) who did not receive any anticancer treatment before ICU admission were included. Most patients had locally advanced disease, and 61 (84.7%) required intensive care due to cancer-related events. In the ICU, 24 (33.3%) patients received chemotherapy, 24 (33.3%) received epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy and 24 (33.3%) received best supportive care (BSC). Patients receiving chemotherapy or EGFR-TKIs in the ICU demonstrated better ICU (p = 0.011) and in-hospital (p = 0.034) survival than those receiving BSC only. Among patients requiring mechanical ventilation, those receiving chemotherapy had higher weaning rates than those receiving EGFR-TKIs or BSC (p = 0.002). In multivariate analysis, receipt of chemotherapy (hazard ratio [HR], 0.443; p = 0.083) and mechanical ventilation (HR, 0.270; p = 0.022) were significantly associated with longer ICU survival after adjusting for clinical factors. Conclusions: Anticancer therapy in the ICU might provide better short-term ICU survival for treatment-naïve, critically ill lung cancer patients.

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“…No entanto, no estudo realizado por Müller et al 10 a prevalência foi do gênero feminino, com 55,9%, e crianças portadoras de câncer, diferentemente do que se evidenciou, pois o presente estudo demonstrou maior exposição a situações de risco por parte do gênero masculino.…”

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Análise de indicadores assistenciais em uma Unidade de Terapia Intensiva Pediátrica na cidade de Fortaleza/CE

et al. 2017

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Resumo Introdução Os indicadores de saúde são medidas que refletem informações sobre diferentes dimensões e atributos da saúde e dos fatores que a determinam. O estudo teve como objetivo analisar os indicadores de uma Unidade de Terapia Intensiva Pediátrica, traçando o perfil do diagnóstico dos pacientes internados na UTI em estudo e verificando as taxas de ocupação, tempo de permanência e outros dados importantes para o hospital. Métodos A pesquisa foi de caráter descritivo, exploratório, longitudinal, documental, prospectivo e de abordagem quantitativa. A coleta de dados foi realizada de Março de 2015 a Fevereiro de 2016, conforme aprovação do Comitê de Ética do referido hospital. Resultados A amostra em estudo tinha como idade média 10,63 ± 0,50 anos, com 73,10 ± 2,45% de prevalência do gênero masculino, onde o Traumatismo Crânio Encefálico (TCE) sobressaiu-se como causa, e a taxa de ocupação no período do estudo foi de 86,13%. Conclusão Concluiu-se que o gênero masculino teve uma prevalência na UTI Pediátrica em relação ao gênero feminino, apresentando como acometimento principal Traumatismo Crânio Encefálico, evidenciando uma média de 8,72 ± 0,47 dias de utilização da ventilação mecânica e 75,30% de taxa de utilização de ventilação mecânica.

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Desfecho de pacientes com câncer de pulmão admitidos em unidades de terapia intensiva

Cited by 21 publications

References 17 publications

Influence of neutropenia on mortality of critically ill cancer patients: results of a meta-analysis on individual data

Influence of neutropenia on mortality of critically ill cancer patients: results of a meta-analysis on individual data

Outcomes of cancer therapy administered to treatment-naïve lung cancer patients in the intensive care unit

Análise de indicadores assistenciais em uma Unidade de Terapia Intensiva Pediátrica na cidade de Fortaleza/CE

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