RT Journal Article
T1 Determinants of mortality in cancer patients with unscheduled admission to the Intensive Care Unit: A prospective multicenter study
A1 Canton-Bulnes, M. L.
A1 Jimenez-Sanchez, M.
A1 Alcantara-Carmona, S.
A1 Gimeno-Costa, R.
A1 Berezo-Garcia, J. A.
A1 Beato, C.
A1 Alvarez-Lerma, F.
A1 Mojal, S.
A1 Olaechea, P.
A1 Gordo-Vidal, F.
A1 Garnacho-Montero, J.
K1 Mortality
K1 Solid cancers
K1 Hematological malignancy
K1 Intensive Care Unit
K1 Mechanical ventilation
K1 Neutropenia
K1 Prognostic-factors
K1 Septic shock
K1 Survival
K1 Outcomes
K1 Icu
AB Objectives: To analyze clinical features associated to mortality in oncological patients with unplanned admission to the Intensive Care Unit (ICU), and to determine whether such risk factors differ between patients with solid tumors and those with hematological malignancies.Design: An observational study was carried out.Setting: A total of 123 Intensive Care Units across Spain.Patients: All cancer patients with unscheduled admission due to acute illness related to the background oncological disease.Interventions: None.Main variables: Demographic parameters, severity scores and clinical condition were assessed, and mortality was analyzed. Multivariate binary logistic regression analysis was performed.Results: A total of 482 patients were included: solid cancer (n = 311) and hematological malignancy (n = 171). Multivariate regression analysis showed the factors independently associated to ICU mortality to be the APACHE II score (OR 1.102; 95% CI 1.064-1.143), medical admission (OR 3.587; 95% CI 1.327-9.701), lung cancer (OR 2.98; 95% CI 1.48-5.99) and mechanical ventilation after the first 24 h of ICU stay (OR 2.27; 95% CI 1.09-4.73), whereas no need for mechanical ventilation was identified as a protective factor (OR 0.15; 95% CI 0.09-0.28). In solid cancer patients, the APACHE II score, medical admission, antibiotics in the previous 48 h and lung cancer were identified as independent mortality indicators, while no need for mechanical ventilation was identified as a protective factor. In the multivariate analysis, the APACHE II score and mechanical ventilation after 24 h of ICU stay were independently associated to mortality in hematological cancer patients, while no need for mechanical ventilation was identified as aprotective factor. Neutropenia was not identified as an independent mortality predictor in either the total cohort or in the two subgroups.Conclusions: The risk factors associated to mortality did not differ significantly between patients with solid cancers and those with hematological malignancies. Delayed intubation inpatients requiring mechanical ventilation might be associated to ICU mortality. (c) 2021 Elsevier Espana, S.L.U. y SEMICYUC. All rights reserved.
PB Elsevier espana slu
SN 0210-5691
YR 2022
FD 2022-12-01
LK http://hdl.handle.net/10668/22382
UL http://hdl.handle.net/10668/22382
LA en
DS RISalud
RD Apr 5, 2025