Critically ill patients with cancer: A clinical perspective

Martos-Benítez, Frank Daniel; Soler-Morejón, Caridad de Dios; Lara-Ponce, Karla Ximena; Orama-Requejo, Versis; Burgos-Aragüez, Dailé; Larrondo-Muguercia, Hilev; Lespoir, Rahim W

doi:10.5306/wjco.v11.i10.809

Cited by 14 publications

(16 citation statements)

References 184 publications

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“…It was reported that 5% of cancer patients need ICU admission because of critical illness within 2 years of malignancy diagnosis (5,8). Cancer patients account for 15% of all admissions to ICU (9). Taccone et al (10) conducted a multicenter, observational study including data from 198 participating ICUs from 24 European countries, in which about 12% of patients admitted to ICUs had a diagnosis of malignancy.…”

Section: Introductionmentioning

confidence: 99%

Short- and medium-term survival of critically ill patients with solid cancer admitted to the intensive care unit

Yuan¹,

Wang²,

Gao³

et al. 2022

Ann Palliat Med

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Background: A great increase in the number of patients needs critical care to the intensive care unit (ICU) due to improvements in oncology. The aim of the study was to explore risk factors affecting survival of critically ill patients with solid cancers in ICU. Methods:The study retrospectively reviewed patients between 2001 and 2012, which were collected by Medical Information Mart for Intensive Care III (MIMIC-III) from the Beth Israel Deaconess Medical Center in Boston, MA, USA.Results: A total of 38,508 adult patients, who were admitted to ICUs and 8,308 (21.6%) were diagnosed as an underlying malignancy; 1,671 and 3,165 adult patients with sold cancer were admitted to surgical ICU (SICU) and medical ICU (MICU), respectively. Patients in SICU had a higher survival rate at the point of 28-, 90-day, and 1-, 3-year than patients in MICU (P<0.001 for all). Multivariate analysis demonstrated that age ≥70, emergency admission, the presence of metastases, Oxford Acute Severity of Illness Score (OASIS) ≥30 and sepsis were independent risk factors affecting 28-day survival in SICU. In MICU, emergency admission, metastatic disease, Sequential Organ Failure Assessment (SOFA) ≥3, Simplified Acute Physiology Score II (SAPS II) ≥39, Acute Physiology Score III (APS III) ≥40, Oxford Acute Severity of Illness Score (OASIS) ≥30, Elixhauser comorbidity index ≥9 and sepsis were independent risk factors for 28-day survival rate. The area under curve (AUC) of the OASIS for predicting ICU mortality was 0.824 [95% confidence interval (CI): 0.805-0.842], which was obviously higher than other scores in SICU. The AUC of the SAPS II for predicting ICU mortality was 0.820 (95% CI: 0.806-0.833), which was slightly higher than other scores in MICU.Conclusions: Patients with cancer in SICU have longer survive time than patients with cancer in MICU.The prediction of prognosis of critically ill cancer patients can guide treatment and optimize medical resources.

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Section: Introductionmentioning

confidence: 99%

Short- and medium-term survival of critically ill patients with solid cancer admitted to the intensive care unit

Yuan¹,

Wang²,

Gao³

et al. 2022

Ann Palliat Med

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“…This demonstrates the importance of early diagnosis to obtain better rates related to the disease, primarily due to the high percentage of these tumors in southern Brazil [16]. Finally, frequent hospital admissions due to tumor worsening led these patients to have low immune resistance, lung infections, cardiovascular disorders, and brain lesions that require speci c care in intensive care centers, further impairing the patients' well-being and debilitating their health, possibly even increasing the risk of death [17]. However, it is crucial to emphasize the di culty of an early diagnosis of these tumors, which may compromise the prognosis and treatment provided by the Brazilian public health system in which these patients were exposed.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of metastases in patients with head and neck tumors in a public radiotherapy service

Souto

Prado

Schuch

et al. 2022

Preprint

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Purpose: To evaluate the prevalence of metastasis and survival rate of patients diagnosed and treated with head and neck cancer and associate them with possible risk factors. Methods: Medical records (June 2013 to April 2020) of patients diagnosed with head and neck tumors treated in the radiotherapy department of a public hospital were retrospectively evaluated. Three hundred and fifty-one patients were selected, and data regarding the patient, disease and treatment were collected and analyzed descriptively. The association between the independent variables and outcomes was determined by univariate analysis using crude odds ratios. Variables with a p-value <0.20 in the univariate analysis were included in a Cox regression model by the stepwise forward method. Kaplan-Meier analyses were also performed. Results: Three hundred and one medical records were included, and most participants were male (84.1%) with a mean age of 63.62 years (±12.19). Eighty-three patients died (27.6%) and 56 (18.6%) developed metastases. A significant association (p=0.046) was found between alcoholism/smoking and death. The presence of metastasis (p=0.039) and advanced staging (p=0.021) also showed an association, increasing the risk of death by over two-fold. Conclusion: A high prevalence of metastasis was found in the patients evaluated, which was a risk factor for death. Other variables also influenced the survival rate of the participating individuals.

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“…Advances in anticancer treatment and survival evaluation are closely linked to the increased number of patients with CRC requiring intensive care [ 4 ]. CRC patients in advanced stages of disease are especially vulnerable to complications with severe infection, acute respiratory failure, cardiovascular events, and neurological disorders; thus these individuals commonly require intensive care [ 5 ]. Recently, mortality rates of CRC patients have decreased with the wide application of advanced organ support techniques.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Utility of Platelet-to-Albumin Ratio among Critically Ill Patients with Colorectal Cancer: A Propensity Score Matching Study

Wang

et al. 2022

Journal of Oncology

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The platelet-to-albumin ratio (PAR) was developed to evaluate inflammatory and nutritional status among patients. The primary goal of the current study was to gain insight into the prognostic role of PAR in critically ill patients with colorectal cancer (CRC). The secondary aim was to develop and verify a clinical model including PAR for the prediction of 28-day mortality. This observational, multicenter study used data from the Medical Information Mart for Intensive Care (MIMIC) IV, e-ICU databases, and Union cohort. Data from 776 critically ill patients with CRC were from the e-ICU database, 219 from the MIMC-IV database, and 135 from the Wuhan Union Hospital. Propensity score matching (PSM) analysis, along with inverse probability treatment weighting, was used to control the influence of confounding factors. Support vector machine (SVM) and LASSO Cox models were then applied to identify significant metrics associated with 28-day mortality in the test cohort. Receiver operating curve (ROC) analysis, along with sensitivity and specificity, was measured to assess the predictive performances of PAR and the survival nomogram. The threshold value for PAR was 8.6, and patients with high PAR (≥8.6) experienced higher 28-day mortality compared to those with low PAR (<8.6). ROC curve analyses revealed that the discriminative ability of PAR was better than platelet count and albumin alone. LASSO Cox regression along with SVM identified six significant metrics associated with 28-day mortality in critically ill patients with CRC, including PAR. The C-index of the critically ill CRC nomogram was 0.802 (0.744–0.859) in the e-ICU training cohort, 0.839 (0.779–0.899) in the e-ICU validation cohort, 0.787 (0.695–0.879) in the MIMIC-IV cohort, and 0.767 (0.703–0.831) in the Union cohort. PAR is a simple score that combines inflammatory and nutritional status. PAR was a reliable index to predict short-term survival outcome of critically ill patients with CRC. Moreover, a clinical nomogram incorporating PAR exhibited satisfactory performance for predicting 28-day mortality of critically ill patients with CRC.

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Critically ill patients with cancer: A clinical perspective

Cited by 14 publications

References 184 publications

Short- and medium-term survival of critically ill patients with solid cancer admitted to the intensive care unit

Short- and medium-term survival of critically ill patients with solid cancer admitted to the intensive care unit

Prevalence of metastases in patients with head and neck tumors in a public radiotherapy service

Prognostic Utility of Platelet-to-Albumin Ratio among Critically Ill Patients with Colorectal Cancer: A Propensity Score Matching Study

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