Opening the doors of the intensive care unit to cancer patients: A current perspective

Ñamendys‐Silva, Silvio A.; Plata-Menchaca, Erika P.; Rivero-Sigarroa, Eduardo; Herrera‐Gómez, Ángel

doi:10.5492/wjccm.v4.i3.159

Cited by 18 publications

(17 citation statements)

References 28 publications

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“…Nevertheless, studies published in recent years have demonstrated similar mortality rates to noncancer ICU patients. The better survival results are attributed to advances in ICU care and better access in this population to critical care [ 15 , 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury Classified by Serum Creatinine and Urine Output in Critically Ill Cancer Patients

Córdova-Sánchez

Herrera‐Gómez

Ñamendys‐Silva

2016

BioMed Research International

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Acute kidney injury (AKI) is common in critically ill patients and is associated with higher mortality. Cancer patients are at an increased risk of AKI. Our objective was to determine the incidence of AKI in our critically ill cancer patients, using the criteria of serum creatinine (SCr) and urine output (UO) proposed by the Kidney Disease: Improving Global Outcomes (KDIGO). Methods. We performed a retrospective cohort analysis of a prospectively collected database at the intensive care unit (ICU) of the Instituto Nacional de Cancerología from January 2013 to March 2015. Results. We classified AKI according to the KDIGO definition. We included 389 patients; using the SCr criterion, 192 (49.4%) had AKI; using the UO criterion, 219 (56.3%) had AKI. Using both criteria, we diagnosed AKI in 69.4% of patients. All stages were independently associated with six-month mortality; stage 1 HR was 2.04 (95% CI 1.14–3.68, p = 0.017), stage 2 HR was 2.73 (95% CI 1.53–4.88, p = 0.001), and stage 3 HR was 4.5 (95% CI 2.25–8.02, p < 0.001). Patients who fulfilled both criteria had a higher mortality compared with patients who fulfilled just one criterion (HR 3.56, 95% CI 2.03–6.24, p < 0.001). Conclusion. We diagnosed AKI in 69.4% of patients. All AKI stages were associated with higher risk of death at six months, even for patients who fulfilled just one AKI criterion.

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Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury Classified by Serum Creatinine and Urine Output in Critically Ill Cancer Patients

Córdova-Sánchez

Herrera‐Gómez

Ñamendys‐Silva

2016

BioMed Research International

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“… 3 , 4 As outcomes in patients with cancer continue to improve, these assumptions may not be valid. 5 A systematic review illustrated that variations in ICU mortality among patients with cancer were largely attributable to differences between study populations’ severity of illness, type of admission, performance status, and need for organ support rather than the presence of cancer. 6 …”

Section: Introductionmentioning

confidence: 99%

Characteristics and Outcomes of Surgical Patients With Solid Cancers Admitted to the Intensive Care Unit

et al. 2018

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Key PointsQuestionHow do features and outcomes vary for surgical patients with and without cancer admitted to the intensive care unit?FindingsIn this cohort study of 25 017 surgical admissions to general intensive care units in the West of Scotland, cancer was a common morbidity at 21.8% of all admissions. Intensive care unit and hospital mortality were lower in the group of intensive care unit patients with cancer; however, this survival advantage had reversed by 6 months.MeaningCancer is present in 1 in 5 intensive care unit surgical admissions, and short-term survival for this group is favorable.

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“… 1 , 2 Physicians in intensive care units (ICUs) are more inclined to consider admitting critically ill patients with cancer worldwide. 3 , 4 One recent population-based study that used a cancer registry database in the United Kingdom reported that approximately 5% of patients with solid tumors required an ICU admission within 2 years of cancer diagnosis. 5 Another multicenter study in Europe found that nearly 1 in 7 patients admitted to ICUs had a malignant neoplasm.…”

Section: Introductionmentioning

confidence: 99%

Association Between Positive Cultures During Admission and 1-Year Mortality in Patients With Cancer Receiving Perioperative Intensive Care

Chiang

Hsu

et al. 2018

Cancer Control

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The number of patients with cancer being admitted to intensive care units (ICUs) is increasing worldwide, and these patients are vulnerable to infection. This study aimed to address the long-term impact of positive cultures during admission on 1-year mortality among patients with cancer who received perioperative intensive care. This retrospective cohort study enrolled adult patients with cancer who were admitted to ICUs and received surgery during 2011 to 2016 at a tertiary hospital in central Taiwan. Cancer-related data were retrieved from the cancer registry, and data during ICU admissions were obtained from the electronic medical records. We compared the survival curves between patients with and without positive clinical cultures using log-rank test and used a multivariable Cox proportional hazards regression model to evaluate the influence of positive clinical cultures on 1-year mortality. A total of 638 patients were included for analyses, and 37.9% of them had positive cultures during the index admission. In-hospital mortality was 9.1%, while 1-year mortality was 21.0%. Compared with patients who survived, patients who died were significantly more likely to have positive cultures (59.7% vs 32.1%), to have a higher Acute Physiology and Chronic Health Evaluation II scores (median 21.8 vs 19.0), and to receive mechanical ventilation (86.6% vs 77.4%). Survival analysis found that positive cultures of blood, the respiratory tract, the urinary tract, or the skin and soft tissue were associated with an increased 1-year mortality. Multivariable Cox proportional hazards regression analysis found that positive cultures of blood, the respiratory tract, the urinary tract, or the skin and soft tissue (hazard ratio: 1.621; 95% confidence interval: 1.087-2.419) were significantly associated with 62.1% increased hazards of death within 1 year after the ICU admission. A positive culture during admission was associated with a worsened long-term survival among patients with cancer who received perioperative intensive care. Further studies are needed to confirm this association.

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Opening the doors of the intensive care unit to cancer patients: A current perspective

Cited by 18 publications

References 28 publications

Acute Kidney Injury Classified by Serum Creatinine and Urine Output in Critically Ill Cancer Patients

Acute Kidney Injury Classified by Serum Creatinine and Urine Output in Critically Ill Cancer Patients

Characteristics and Outcomes of Surgical Patients With Solid Cancers Admitted to the Intensive Care Unit

Association Between Positive Cultures During Admission and 1-Year Mortality in Patients With Cancer Receiving Perioperative Intensive Care

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