Ghiath AlSaied, Hani Lababidi, Taher AlHawdar, Saud AlZahrani, Abdullah AlMotairi, Mohamad AlMaani
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The following variables were collected: age, gender, ICU length of stay (LOS), APACHE II score, type of malignancy, febrile neutropenia, source and time of admission, and need for mechanical ventilation (MV), renal replacement therapy (RRT), and treatment with vasopressors (VP). Predictors of mortality and survival rates at 28 days and 3, 6, and 12 months were calculated.</p><p><strong>Results: </strong>The study included 410 cancer patients with 466 unplanned ICU admissions. Of these, 52% had NHM. The average LOS in the ICU was 9.6 days and the mean APACHE score was 21.9. MV was needed in 73% of the patients, RRT in 15%, and VP in 24%, while febrile neutropenia was present in 24%. There were statistically significant differences between survivors and non-survivors in the APACHE II score (17.7 ± 8.0 vs. 25.6 ± 9.2), MV use (52% vs. 92%), need for RRT (6% vs. 23%), VP use (42% vs. 85%), and presence of febrile neutropenia (18% vs. 30%). The predictors of mortality were need for MV (OR = 4.97), VP (OR = 3.43), RRT (OR = 3.31), and APACHE II score (OR = 1.10). Survival rates at 28 days, 3, 6, and 12 months were 52%, 28%, 22%, and 15%, respectively.</p><p><strong>Conclusion: </strong>The survival rate of cancer patients with an unplanned admission to the ICU remains low. Predictors of mortality include need for MV, RRT, and VP and presence of febrile neutropenia. 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The following variables were collected: age, gender, ICU length of stay (LOS), APACHE II score, type of malignancy, febrile neutropenia, source and time of admission, and need for mechanical ventilation (MV), renal replacement therapy (RRT), and treatment with vasopressors (VP). Predictors of mortality and survival rates at 28 days and 3, 6, and 12 months were calculated.</p><p><strong>Results: </strong>The study included 410 cancer patients with 466 unplanned ICU admissions. Of these, 52% had NHM. The average LOS in the ICU was 9.6 days and the mean APACHE score was 21.9. MV was needed in 73% of the patients, RRT in 15%, and VP in 24%, while febrile neutropenia was present in 24%. There were statistically significant differences between survivors and non-survivors in the APACHE II score (17.7 ± 8.0 vs. 25.6 ± 9.2), MV use (52% vs. 92%), need for RRT (6% vs. 23%), VP use (42% vs. 85%), and presence of febrile neutropenia (18% vs. 30%). The predictors of mortality were need for MV (OR = 4.97), VP (OR = 3.43), RRT (OR = 3.31), and APACHE II score (OR = 1.10). Survival rates at 28 days, 3, 6, and 12 months were 52%, 28%, 22%, and 15%, respectively.</p><p><strong>Conclusion: </strong>The survival rate of cancer patients with an unplanned admission to the ICU remains low. Predictors of mortality include need for MV, RRT, and VP and presence of febrile neutropenia. 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引用次数: 0
摘要
背景：了解计划外入住重症监护室的癌症患者的特征和预后对于治疗决策和预后至关重要：描述需要意外入住重症监护病房的血液和非血液恶性肿瘤（NHM）患者的临床特征，并确定死亡率和长期生存率的预测因素：这项回顾性研究纳入了沙特阿拉伯一家三级甲等医院 2011 年至 2016 年期间意外入住 ICU 的所有癌症患者。研究收集了以下变量：年龄、性别、重症监护室住院时间（LOS）、APACHE II评分、恶性肿瘤类型、发热性中性粒细胞减少症、入院来源和时间，以及是否需要机械通气（MV）、肾脏替代治疗（RRT）和使用血管加压剂（VP）治疗。计算了28天、3、6和12个月的死亡率和存活率：研究共纳入了 410 名癌症患者，其中 466 人意外入住重症监护病房。其中 52% 患有 NHM。在重症监护室的平均住院时间为 9.6 天，平均 APACHE 评分为 21.9 分。73%的患者需要 MV，15%的患者需要 RRT，24%的患者需要 VP，24%的患者出现发热性中性粒细胞减少症。在 APACHE II 评分（17.7 ± 8.0 vs. 25.6 ± 9.2）、MV 使用率（52% vs. 92%）、RRT 需求（6% vs. 23%）、VP 使用率（42% vs. 85%）和发热性中性粒细胞减少症（18% vs. 30%）方面，幸存者和非幸存者之间存在显著统计学差异。预测死亡率的因素是需要 MV（OR = 4.97）、VP（OR = 3.43）、RRT（OR = 3.31）和 APACHE II 评分（OR = 1.10）。28天、3个月、6个月和12个月的存活率分别为52%、28%、22%和15%：结论：计划外入住重症监护室的癌症患者的存活率仍然很低。死亡率的预测因素包括需要 MV、RRT 和 VP 以及发热性中性粒细胞减少症。约85%的癌症患者在入住重症监护室后一年内死亡。
Outcome of Cancer Patients with an Unplanned Intensive Care Unit Admission: Predictors of Mortality and Long-term Survival.
Background: Understanding the characteristics and outcomes of cancer patients with unplanned ICU admission is imperative for therapeutic decisions and prognostication purposes.
Objective: To describe the clinical characteristics of patients with hematological and non-hematological malignancies (NHM) who require unplanned ICU admission and to determine the predictors of mortality and long-term survival.
Methods: This retrospective study included all patients with cancer who had an unplanned ICU admission between 2011 and 2016 at a tertiary hospital in Saudi Arabia. The following variables were collected: age, gender, ICU length of stay (LOS), APACHE II score, type of malignancy, febrile neutropenia, source and time of admission, and need for mechanical ventilation (MV), renal replacement therapy (RRT), and treatment with vasopressors (VP). Predictors of mortality and survival rates at 28 days and 3, 6, and 12 months were calculated.
Results: The study included 410 cancer patients with 466 unplanned ICU admissions. Of these, 52% had NHM. The average LOS in the ICU was 9.6 days and the mean APACHE score was 21.9. MV was needed in 73% of the patients, RRT in 15%, and VP in 24%, while febrile neutropenia was present in 24%. There were statistically significant differences between survivors and non-survivors in the APACHE II score (17.7 ± 8.0 vs. 25.6 ± 9.2), MV use (52% vs. 92%), need for RRT (6% vs. 23%), VP use (42% vs. 85%), and presence of febrile neutropenia (18% vs. 30%). The predictors of mortality were need for MV (OR = 4.97), VP (OR = 3.43), RRT (OR = 3.31), and APACHE II score (OR = 1.10). Survival rates at 28 days, 3, 6, and 12 months were 52%, 28%, 22%, and 15%, respectively.
Conclusion: The survival rate of cancer patients with an unplanned admission to the ICU remains low. Predictors of mortality include need for MV, RRT, and VP and presence of febrile neutropenia. About 85% of cancer patients died within 1 year after ICU admission.
期刊介绍：
Saudi Journal of Medicine & Medical Sciences (SJMMS) is the official scientific journal of Imam Abdulrahman Bin Faisal University. It is an international peer-reviewed, general medical journal. The scope of the Journal is to publish research that will be of interest to health specialties both in academic and clinical practice. The Journal aims at disseminating high-powered research results with the objective of turning research into knowledge. It seeks to promote scholarly publishing in medicine and medical sciences. The Journal is published in print and online. The target readers of the Journal include all medical and health professionals in the health cluster such as in medicine, dentistry, nursing, applied medical sciences, clinical pharmacology, public health, etc.
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