0 191

Cited 10 times in

Prediction of short- and long-term survival for advanced cancer patients after ICU admission

 Su Jin Heo  ;  Gyuri Kim  ;  Choong-kun Lee  ;  Kyung Soo Chung  ;  Hye Jin Choi  ;  Joohyuk Sohn  ;  Soohyeon Lee 
 SUPPORTIVE CARE IN CANCER, Vol.23(6) : 1647-1655, 2015 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Neoplasms/diagnosis* ; Neoplasms/mortality* ; Prognosis ; Republic of Korea/epidemiology ; Retrospective Studies ; Survival Rate
Intensive care unit ; Advanced cancer ; Short-term survival rate ; Long-term survival rate
BACKGROUND: Intensive care unit (ICU) admission of advanced cancer patients is controversial because it is associated with poor short-term prognosis. However, ICU admission of these patients might also result in administration of specific anticancer treatments and evaluation of tumor characteristics, which could influence long-term outcomes. Herein, we investigate whether there is a relationship between ICU admission and long-term outcomes for advanced cancer patients. METHODS: We analyzed 116 advanced cancer patients who were admitted to the ICU at Severance Hospital, Yonsei University, between January 2010 and December 2012. We excluded palliative care-only patients. We analyzed demographic, clinical, and survival data of patients admitted to the ICU, and we identified patient characteristics that were measured upon presentation to ICU to determine whether any of these are prognostic or predictive factors of short- or long-term survival. RESULTS: The median age of our study sample was 64 years. Sixty-nine (59.5 %) patients were male. Lung, breast, and stomach were the most common primary tumor sites. Eighty-seven (75 %) patients had received active anticancer treatment within the past 30 days. The main cause of ICU admission was acute respiratory failure (73 %); thus, 102 (87.9 %) patients were managed with conventional mechanical ventilation, 99 (85.3 %) patients in vasopressor and 31 (26.7 %) patients received continuous renal replacement therapy (CRRT). Twenty-four (20.7 %) patients were in postresuscitation status before ICU admission. The ICU, hospital, and 6-month survival rates were 51.7, 31.0, and 15.5 %, respectively. APACHE II score (HR 2.86, 95 % CI 1.00-8.15, P < 0.050) and need for CRRT (HR 2.14, 95 % CI 1.24-3.70, P < 0.007) were associated with ICU mortality in a Cox-regression model. Eastern Cooperative Oncology Group (ECOG) performance status (HR 1.64, 95 % CI 1.03-2.62, P < 0.010) was associated with poor prognosis, and controlled disease status (HR 0.372, 95 % CI 0.21-0.67, P < 0.001) was found to be a good prognostic factor for 6-month survival after ICU admission. CONCLUSIONS: Clinical factors associated with acute, critical status upon ICU admission, such as APACHE II score and need of CRRT, were associated with a higher risk of ICU mortality and short-term mortality than factors directly associated with the patient's cancer. To understand the relationship between ICU admission and long-term survival, however, we have to apply more comprehensive approach that also considers tumor characteristics and disease control status.
Full Text
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Gyuri(김규리)
Sohn, Joo Hyuk(손주혁) ORCID logo https://orcid.org/0000-0002-2303-2764
Lee, Soo Hyeon(이수현)
Lee, Choong Kun(이충근)
Jung, Kyung Soo(정경수) ORCID logo https://orcid.org/0000-0003-1604-8730
Choi, Hye Jin(최혜진) ORCID logo https://orcid.org/0000-0001-5917-1400
Heo, Su Jin(허수진) ORCID logo https://orcid.org/0000-0002-0615-5869
사서에게 알리기


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.