Mortality of Adult Critically Ill Subjects With Cancer

Rosa, Régis Goulart; Tonietto, Túlio Frederico; Duso, Bruno Achutti; Maccari, Juçara Gasparetto; Oliveira, Roselaine Pinheiro de; Rutzen, W; Madeira, L; Ascoli, Aline Maria; Hessler, Rachel; Morandi, Paola; Cremonese, Ricardo Viegas; Neto, Felippe Leopoldo Dexheimer; Tagliari, Luciana Vilela; Balzano, Patrícia de Campos; Barth, J; Teixeira, Cassiano

doi:10.4187/respcare.05210

Cited by 14 publications

(6 citation statements)

References 29 publications

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“…In the study, cancer patients in MICU have a higher incidence of organ dysfunction and require more intensive support (such as MV, vasopressors, and RRT), which was consistent with previous literature (20). Patients in SICU Recent advance in anti-cancer treatment has gradually improved the overall survival of patients with metastatic cancer (22,23).…”

Section: Discussionsupporting

confidence: 88%

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: Discussionsupporting

confidence: 88%

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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“…In the present study, patients with cancer had a greater need for intensive support (eg, MV, vasopressor administration, and RRT), which was consistent with previous literature [24]. In patients with MV support, we found that noncancer patients had survive advantage at the point of 28-day and 90-day after ICU admission.…”

Section: Discussionsupporting

confidence: 91%

The Effect of the Underlying Malignancy on Short- and Medium-Term Survival of Critically Ill Patients Admitted to the Intensive Care Unit : A Retrospective Analysis Based on Propensity Score Matching

Yuan

Wang

Gao

et al. 2020

Preprint

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Background Advances in oncology led to a substantial increase in the number of patients requiring admission to the ICU. It is significant to confirm which cancer critical patients can benefit from the ICU care service like noncancer patients. Methods An observational retrospective cohort study using intensive care unit (ICU) admissions of Medical Information Mart for Intensive Care III from the Beth Israel Deaconess Medical Center in Boston, MA, USA between 2001 and 2012 was conducted. Propensity score matching was used to reduce the imbalance between two matched cohorts. ICU patients with cancer were compared with those without cancer in terms of patients’ characteristics and survival. Results There were 38,508 adult patients admitted to ICUs during the period. The median age was 65 years (IQR, 52-77) and 8,308 (21.8%) had an underlying malignancy diagnosis. The noncancer group had a significant survive advantage at the point of 28-day, 90-day, 365-day and 1095-day after ICU admission compared with cancer group (P < 0.001 for all) after PSM. Subgroup analysis showed that the diagnosis of malignancy didn’t decrease 28-day and 90-day survive when patients’ age ≥65-year, patients in surgical intensive care unit or cardiac surgery recovery unit or traumatic surgical intensive care unit, elective admission, patients with renal replacement therapy or vasopressor support (P > 0.05 for all). Conclusions Malignancy is a common diagnosis among ICU patients. Patients without cancer have a survive advantage compared with patients with cancer in the short- and medium-term. However, in selected groups, cancer critical patients can benefit from the ICU care service like noncancer patients in the short-term.

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“…Unfortunately, in our study 9 we did not compare the mortality rates of patients with solid neoplasms with those with hematological neoplasms, and this remains as an evidence gap due to the scarce literature about this issue. Some studies have shown that subjects with hematological malignancies have higher ICU mortality rates when compared with subjects with solid cancers.…”

Section: Prognosis Of Cancer Patients In the Icu: Much Work Remains-rmentioning

confidence: 94%

Prognosis of Cancer Patients in the ICU: Much Work Remains—Reply

2017

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Mortality of Adult Critically Ill Subjects With Cancer

Abstract: The present study failed to show an association between malignancy and all-cause 30-d mortality rate in adult subjects admitted to a mixed medical-surgical ICU. The propensity score-matched analysis showed no evidence of excessive mortality due to cancer diagnosis.

Cited by 14 publications

References 29 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

The Effect of the Underlying Malignancy on Short- and Medium-Term Survival of Critically Ill Patients Admitted to the Intensive Care Unit : A Retrospective Analysis Based on Propensity Score Matching

Prognosis of Cancer Patients in the ICU: Much Work Remains—Reply

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