ASSESSMENT OF OUTCOMES OF MALIGNANCY PATIENTS ADMITTED IN INTENSIVE CARE UNITS

Authors

  • R PERVAIZ Department of Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan
  • B ARIF Department of Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan
  • T SARWAR Department of Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan
  • AZ RIZVI Department of Medicine, Bahria International Hospital, Lahore, Pakistan
  • MU MUNAWAR Department of Medicine, Bahria International Hospital, Lahore, Pakistan.
  • H KANDEEL Department of Critical Care Medicine, Hatta Hospital, Dubai Health, Dubai, UAE
  • AHA AWAD Department of Medical Intensive Care Unit, Rashid Hospital, Dubai Health, Dubai, UAE.

DOI:

https://doi.org/10.54112/pjicm.v3i02.18

Keywords:

Intensive Care Unit, Risk Factors, Malignancy, Mortality

Abstract

Background: The decision to admit advanced cancer patients to the intensive care unit (ICU) is multifaceted, considering factors such as prognosis and quality of life. Objectives: The objective of this study was to identify mortality risk factors in critically ill advanced cancer patients admitted to the ICU. Study Design: This was an observational study. Setting: The study was conducted at Bahria International Hospital, Lahore. Duration of Study: The study was conducted between March 2022 and March 2023.Material and Methods: A total of 65 adult cancer patients admitted non-electively to the ICU were enrolled in the study. Data on demographics, clinical conditions, and outcomes were collected. Independent medical decisions were collected by ICU staff. Results: The ICU mortality rate was 34.6%, increased to 59.4% within thirty days post-discharge. Patients spent an average of 15.2 days in the ICU. Common admission reasons included respiratory failure (36.2%) and sepsis/septic shock (59.2%). Cox regression analysis revealed six significant indicators of poor outcomes: acute kidney injury (AKI), sepsis with multiple organ failure (MOF), acute respiratory distress syndrome (ARDS), uncontrolled malignancy, mechanical ventilation, and vasopressor use. Conclusion: Our findings highlight AKI, sepsis, MOF, ARDS, and uncontrolled malignancy as prognostic predictors of early death in critically ill cancer patients admitted to the ICU. Additionally, mechanical ventilation and vasopressor use are associated with increased mortality risk. These insights can aid clinicians in optimizing care strategies for cancer patients

References

Organization WH. WHO report on cancer: setting priorities, investing wisely and providing care for all. 2020.

Auclin E, Charles-Nelson A, Abbar B, Guérot E, Oudard S, Hauw-Berlemont C, et al. Outcomes in elderly patients admitted to the intensive care unit with solid tumors. Annals of Intensive Care. 2017;7:1-8.

Aygencel G, Turkoglu M, Sucak GT, Benekli M. Prognostic factors in critically ill cancer patients admitted to the intensive care unit. Journal of critical care. 2014;29(4):618-26.

Hawari FI, Nazer LH, Addassi A, Rimawi D, Jamal K. Predictors of ICU admission in patients with cancer and the related characteristics and outcomes: a 5-year registry-based study. Critical care medicine. 2016;44(3):548-53.

Reddy DRS, Botz GH. Triage and prognostication of cancer patients admitted to the intensive care unit. Critical Care Clinics. 2021;37(1):1-18.

Sridharan G, Fleury Y, Hergafi L, Doll S, Ksouri H. Triage of Critically Ill Patients: Characteristics and Outcomes of Patients Refused as Too Well for Intensive Care. Journal of Clinical Medicine. 2023;12(17):5513.

Patel VN, Stone SD. Patients with advanced cancer requiring intensive care: reasons for ICU admission, mortality outcomes, and the role of palliative care. AACN Advanced Critical Care. 2021;32(3):324-31.

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2018;68(6):394-424.

Torre LA, Sauer AMG, Chen Jr MS, Kagawa‐Singer M, Jemal A, Siegel RL. Cancer statistics for Asian Americans, Native Hawaiians, and Pacific Islanders, 2016: Converging incidence in males and females. CA: a cancer journal for clinicians. 2016;66(3):182-202.

Oeyen S, Benoit D, Annemans L, Depuydt P, Van Belle S, Troisi R, et al. Long-term outcomes and quality of life in critically ill patients with hematological or solid malignancies: a single center study. Intensive care medicine. 2013;39:889-98.

Soares M, Caruso P, Silva E, Teles JM, Lobo SM, Friedman G, et al. Characteristics and outcomes of patients with cancer requiring admission to intensive care units: a prospective multicenter study. Critical care medicine. 2010;38(1):9-15.

Borcoman E, Dupont A, Mariotte E, Doucet L, Joseph A, Chermak A, et al. One-year survival in patients with solid tumours discharged alive from the intensive care unit after unplanned admission: a retrospective study. Journal of Critical Care. 2020;57:36-41.

Vijenthira A, Chiu N, Jacobson D, Freedman Z, Cheung MC, Goddard S, et al. Predictors of intensive care unit admission in patients with hematologic malignancy. Scientific Reports. 2020;10(1):21145.

Chang Y, Huh J-W, Hong S-B, Lee DH, Suh C, Kim S-W, et al. Outcomes and prognostic factors of patients with lung cancer and pneumonia-induced respiratory failure in a medical intensive care unit: a single-center study. Journal of critical care. 2014;29(3):414-9.

Heo SJ, Kim G, Lee C-k, Chung KS, Choi HJ, Sohn J, et al. Prediction of short-and long-term survival for advanced cancer patients after ICU admission. Supportive Care in Cancer. 2015;23:1647-55.

Anisoglou S, Asteriou C, Barbetakis N, Kakolyris S, Anastasiadou G, Pnevmatikos I. Outcome of lung cancer patients admitted to the intensive care unit with acute respiratory failure. Hippokratia. 2013;17(1):60.

BIKMAZ ŞGA, Gökçe O, Haşimoğlu MM, BOYACI N, Türkoğlu M, Yegin ZA, et al. Risk factors for ICU mortality in patients with hematological malignancies: a singlecenter, retrospective cohort study from Turkey. Turkish Journal of Medical Sciences. 2023;53(1):340-51.

Xia R, Wang D. Intensive care unit prognostic factors in critically ill patients with advanced solid tumors: a 3-year retrospective study. BMC cancer. 2016;16(1):1-7.

Vigneron C, Charpentier J, Valade S, Alexandre J, Chelabi S, Palmieri L-J, et al. Patterns of ICU admissions and outcomes in patients with solid malignancies over the revolution of cancer treatment. Annals of Intensive Care. 2021;11(1):1-10.

Assi HI, Halim NA, Alameh I, Khoury J, Nahra V, Sukhon F, et al. Outcomes of patients with malignancy admitted to the intensive care units: a prospective study. Critical Care Research and Practice. 2021;2021.

Gupta R, Heshami N, Jay C, Ramesh N, Song J, Lei X, et al. Predictors of survival in patients with sarcoma admitted to the intensive care unit. Clinical sarcoma research. 2016;6(1):1-12.

Horster S, Stemmler HJ, Mandel PC, Mück A, Tischer J, Hausmann A, et al. Mortality of patients with hematological malignancy after admission to the intensive care unit. Onkologie. 2012;35(10):556-61.

Hwang KE, Seol CH, Hwang YR, Jo HG, Park SH, Yoon KH, et al. The prognosis of patients with lung cancer admitted to the medical intensive care unit. Asia‐Pacific Journal of Clinical Oncology. 2016;12(1):e118-e24.

Parakh S, Piggin A, Neeman T, Mitchell I, Crispin P, Davis A. Outcomes of haematology/oncology patients admitted to intensive care unit at T he C anberra H ospital. Internal medicine journal. 2014;44(11):1087-94.

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Published

2023-08-14

How to Cite

PERVAIZ , R., ARIF , B., SARWAR , T., RIZVI, A., MUNAWAR , M., KANDEEL , H., & AWAD , A. (2023). ASSESSMENT OF OUTCOMES OF MALIGNANCY PATIENTS ADMITTED IN INTENSIVE CARE UNITS. Pakistan Journal of Intensive Care Medicine, 3(02), 18. https://doi.org/10.54112/pjicm.v3i02.18

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Original Research Articles

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