Early intervention on the outcomes in critically ill cancer patients admitted to intensive care units |
| |
Authors: | Jae-Uk Song Gee Young Suh Hye Yun Park So Yeon Lim Seo Goo Han Yeh Rim Kang O. Jung Kwon Sookyoung Woo Kyeongman Jeon |
| |
Affiliation: | Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Republic of Korea. |
| |
Abstract: | Purpose To determine whether earlier intervention was associated with decreased mortality in critically ill cancer patients admitted to an intensive care unit (ICU). Methods A retrospective observational study was performed of 199 critically ill cancer patients admitted to the ICU from the general ward between January 2010 and December 2010. A logistic regression model was used to adjust for potential confounding factors in the association between time to intervention and in-hospital mortality. Results In-hospital mortality was 52?%, with a median Simplified Acute Physiology Score 3 (SAPS 3) of 80 [interquartile range (IQR) 67–93], and a median Sequential Organ Failure Assessment (SOFA) score of 8 (IQR 5–11). Median time from physiological derangement to intervention (time to intervention) prior to ICU admission was 1.5 (IQR 0.6–4.3)?h. Median time to intervention was significantly shorter in survivors than in non-survivors (0.9 vs. 3.0?h; p?0.001). Additionally, the mortality rates increased significantly with increasing quartiles of time to intervention (p?0.001, test for trend). Other factors associated with in-hospital mortality were severity of illness, performance status, hematologic malignancy, stem-cell transplantation, presence of three or more abnormal physiological variables, time from derangement to ICU admission, presence of infection, need for mechanical ventilation and vasopressor, and low PaO2/FiO2 ratio. Even after adjusting for potential confounding factors, time to intervention was still significantly associated with hospital mortality (adjusted odds ratio 1.445, 95?% confidence interval 1.217–1.717). Conclusions Early intervention before ICU admission was independently associated with decreased in-hospital mortality in critically ill cancer patients admitted to the ICU. |
| |
Keywords: | |
本文献已被 PubMed SpringerLink 等数据库收录! |
|