Characteristics and short-term outcomes of patients with esophageal cancer with unplanned intensive care unit admissions: a retrospective cohort study

Abstract

Objective To depict the clinical presentation and outcomes of a cohort of critically ill patients with esophageal cancer. Methods We carried out a multicenter retrospective study that included patients with esophageal cancer admitted to intensive care units with acute illness between September 2009 and December 2017. We collected the demographic and clinical characteristics of all included patients, as well as organ-support measures and hospital outcomes. We performed logistic regression analysis to identify independent factors associated with in-hospital mortality. Results Of 226 patients included in the study, 131 (58.0%) patients died before hospital discharge. Squamous cell carcinoma was more frequent than adenocarcinoma, and 124 (54.9%) patients had metastatic cancer. The main reasons for admission were sepsis/septic shock and acute respiratory failure. Mechanical ventilation (OR = 6.18; 95%CI 2.86 - 13.35) and metastatic disease (OR = 7.10; 95%CI 3.35 - 15.05) were independently associated with in-hospital mortality. Conclusion In this cohort of patients with esophageal cancer admitted to intensive care units with acute illness, the in-hospital mortality rate was very high. The requirement for invasive mechanical ventilation and metastatic disease were independent prognostic factors and should be considered in discussions about the short-term outcomes of these patients.

A Systematic Review and Meta-Analysis Evaluating Geographical Variation in Outcomes of Cancer Patients Treated in ICUs

“…All studies had a total Newcastle-Ottawa score of 7 or higher, indicating a low risk of bias ( eTable 3 , http://links.lww.com/CCX/B54). Among the 46 studies, five did not report ICU mortality data (42, 47, 48, 52, 54). The risks of selection, attrition, outcome, and missing data biases were judged to be low for all included studies.…”

“…The characteristics of the 46 included studies are described in eTable 1 (http://links.lww.com/CCX/B54). Most of the published literature was from Europe ( n = 18) (15–32), followed by Asia ( n = 12) (33–44), North America ( n = 9) (4, 45–52), South America ( n = 5) (5, 53–56), and Oceania ( n = 2) (57, 58). On the other hand, studies from North America contributed the highest number of patients ( n = 37,255), followed by South America ( n = 32,723), Asia ( n = 23,540), Europe ( n = 16,149), and Oceania ( n = 478).…”

“…Thirty-seven studies reported data on length of stay in the ICU (4, 5, 16–19, 21, 23–25, 28, 29, 32–36, 38–52, 54–58). The WM length of stay was 5.9 days (95% CI, 5.3–6.5 d), and the median was 5.7 days (range, 2.7–23.7 d).…”

Scientific Publications on Nursing for COVID-19 in Patients With Cancer: Scoping Review

“…In this context, it is noteworthy that patients with cancer are susceptible to developing infections. Despite the benefits of cancer treatment, it may cause the expansion of immunosuppression, making these patients more vulnerable to bacterial, fungal, and viral infections [ 2 ].…”