Prediction of short- and long-term survival for advanced cancer patients after ICU admission

Heo, Su Jin; Kim, Gyuri; Lee, Choong-kun; Chung, Kyung Soo; Choi, Hye Jin; Sohn, Joohyuk; Lee, Soo Hyun

doi:10.1007/s00520-014-2519-2

Cited by 22 publications

(20 citation statements)

References 37 publications

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“…Third, the proportion of patients admitted with each cancer type reflects the range of tertiary services based at our hospital and the data may not be generalisable to general ICUs in hospitals without a tertiary cancer service. Fourth, patients admitted to our ICU were less sick with lower APACHE II and SOFA Scores on day of admission compared to other similar studies in the literature, 28 29 43 48 which may reflect differences in admission policy and bed availability. The Guy's Hospital site has no separate high-dependency unit, and 37.3% of patients in our study did not require organ support at time of admission, rather they were admitted for enhanced monitoring.…”

Section: Discussionmentioning

confidence: 56%

“…Most studies have demonstrated an association between short-term mortality and severity of acute illness, 27–30 greater number of failed organ systems 31–37 and increased requirement for organ support including mechanical ventilation, 23 30 38–40 vasopressors 36 38 39 41 and RRT. 29 42 Our analysis showed that APACHE II Score on admission to ICU was independently associated with worse hospital and 180-day mortality. Although a greater number of failed organ systems and the need for organ support at ICU admission were associated with worse hospital mortality in univariate analysis, only the need for RRT remained an independent risk factor for 180-day mortality.…”

Section: Discussionmentioning

confidence: 74%

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Short-term and medium-term survival of critically ill patients with solid tumours admitted to the intensive care unit: a retrospective analysis

et al. 2016

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ObjectivesPatients with cancer frequently require unplanned admission to the intensive care unit (ICU). Our objectives were to assess hospital and 180-day mortality in patients with a non-haematological malignancy and unplanned ICU admission and to identify which factors present on admission were the best predictors of mortality.DesignRetrospective review of all patients with a diagnosis of solid tumours following unplanned admission to the ICU between 1 August 2008 and 31 July 2012.SettingSingle centre tertiary care hospital in London (UK).Participants300 adult patients with non-haematological solid tumours requiring unplanned admission to the ICU.InterventionsNone.Primary and secondary outcomesHospital and 180-day survival.Results300 patients were admitted to the ICU (median age 66.5 years; 61.7% men). Survival to hospital discharge and 180 days were 69% and 47.8%, respectively. Greater number of failed organ systems on admission was associated with significantly worse hospital survival (p<0.001) but not with 180-day survival (p=0.24). In multivariate analysis, predictors of hospital mortality were the presence of metastases (OR 1.97, 95% CI 1.08 to 3.59), Acute Physiology and Chronic Health Evaluation II (APACHE II) Score (OR 1.07, 95% CI 1.01 to 1.13) and a Glasgow Coma Scale Score <7 on admission to ICU (OR 5.21, 95% CI 1.65 to 16.43). Predictors of worse 180-day survival were the presence of metastases (OR 2.82, 95% CI 1.57 to 5.06), APACHE II Score (OR 1.07, 95% CI 1.01 to 1.13) and sepsis (OR 1.92, 95% CI 1.09 to 3.38).ConclusionsShort-term and medium-term survival in patients with solid tumours admitted to ICU is better than previously reported, suggesting that the presence of cancer alone should not be a barrier to ICU admission.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 74%

Short-term and medium-term survival of critically ill patients with solid tumours admitted to the intensive care unit: a retrospective analysis

et al. 2016

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“…A number of patients treated in an ICU have a difficult time returning to their lives after hospitalization and the health of some patients continued to decline following discharge [4][5][6]. The studies on long-term outcomes of ICU survivors are rare in Korea [7,8]. The long-term outcomes are much more difficult to follow-up and certain predictors for mortality after ICU discharge (e.g., quality of life and psychological problems) are not easily measurable.…”

Section: Discussionmentioning

confidence: 99%

Long-term mortality of patients discharged from the hospital after successful critical care in the ICU in Korea: a retrospective observational study in a single tertiary care teaching hospital

Shin

Kim

et al. 2020

Korean J Anesthesiol

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Background: The long-term outcomes of patients discharged from the hospital after successful care in intensive care unit (ICU) are not briskly evaluated in Korea. The aim of this study was to assess long-term mortality of patients treated in the ICU and discharged alive from the hospital and to identify predictive factors of mortality. Methods: In 3,679 adult patients discharged alive from the hospital after ICU care between 2006 and 2011, the 1-year mortality rate (primary outcome measure) was investigated. Various factors were entered into multivariate analysis to identify independent factors of 1-year mortality, including sex, age, severity of illness (Acute Physiology and Chronic Health Evaluation [APACHE] II score), mechanical ventilation, malignancy, readmission, type of admission (emergency, elective surgery, and medical), and diagnostic category (trauma and non-trauma). Results: The 1-year mortality rate was 13.4%. Risk factors that were associated with 1-year mortality included age (hazard ratio: 1.03 [95% CI,

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“…Our results indicate that the prognostic factors important for the general population requiring PMV cannot be directly applied to cancer patients requiring PMV. In cancer patients requiring mechanical ventilation, several studies have shown that cancer status is an independent risk factor for increased mortality 7–9, 24 . We further found that weaning outcome was significantly related to long-term survival in cancer patients requiring PMV, even in patients with an uncontrolled cancer status.…”

Section: Discussionmentioning

confidence: 99%

Significant Clinical Factors Associated with Long-term Mortality in Critical Cancer Patients Requiring Prolonged Mechanical Ventilation

Keng

Chung

Lin

et al. 2017

Sci Rep

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Studies about prognostic assessment in cancer patients requiring prolonged mechanical ventilation (PMV) for post-intensive care are scarce. We retrospectively enrolled 112 cancer patients requiring PMV support who were admitted to the respiratory care center (RCC), a specialized post-intensive care weaning facility, from November 2009 through September 2013. The weaning success rate was 44.6%, and mortality rates at hospital discharge and after 1 year were 43.8% and 76.9%, respectively. Multivariate logistic regression showed that weaning failure, in addition to underlying cancer status, was significantly associated with an increased 1-year mortality (odds ratio, 6.269; 95% confidence interval, 1.800–21.834; P = 0.004). Patients who had controlled non-hematologic cancers and successful weaning had the longest median survival, while those with other cancers who failed weaning had the worst. Patients with low maximal inspiratory pressure, anemia, and poor oxygenation at RCC admission had an increased risk of weaning failure. In conclusion, cancer status and weaning outcome were the most important determinants associated with long-term mortality in cancer patients requiring PMV. We suggest palliative care for those patients with clinical features associated with worse outcomes. It is unknown whether survival in this specific patient population could be improved by modifying the risk of weaning failure.

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Prediction of short- and long-term survival for advanced cancer patients after ICU admission

Cited by 22 publications

References 37 publications

Short-term and medium-term survival of critically ill patients with solid tumours admitted to the intensive care unit: a retrospective analysis

Short-term and medium-term survival of critically ill patients with solid tumours admitted to the intensive care unit: a retrospective analysis

Long-term mortality of patients discharged from the hospital after successful critical care in the ICU in Korea: a retrospective observational study in a single tertiary care teaching hospital

Significant Clinical Factors Associated with Long-term Mortality in Critical Cancer Patients Requiring Prolonged Mechanical Ventilation

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