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29.05.2019 | Systematic Review

Changes in critically ill cancer patients’ short-term outcome over the last decades: results of systematic review with meta-analysis on individual data

verfasst von: Michaël Darmon, Aurélie Bourmaud, Quentin Georges, Marcio Soares, Kyeongman Jeon, Sandra Oeyen, Chin Kook Rhee, Pascale Gruber, Marlies Ostermann, Quentin A. Hill, Pieter Depuydt, Christelle Ferra, Anne-Claire Toffart, Peter Schellongowski, Alice Müller, Virginie Lemiale, Djamel Mokart, Elie Azoulay

Erschienen in: Intensive Care Medicine | Ausgabe 7/2019

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Abstract

Purpose

The number of averted deaths due to therapeutic advances in oncology and hematology is substantial and increasing. Survival of critically ill cancer patients has also improved during the last 2 decades. However, these data stem predominantly from unadjusted analyses. The aim of this study was to assess the impact of ICU admission year on short-term survival of critically ill cancer patients, with special attention on those with neutropenia.

Methods

Systematic review and meta-analysis of individual data according to the guidelines of meta-analysis of observational studies in epidemiology.

Datasource

Pubmed and Cochrane databases.

Eligibility criteria

Adult studies published in English between May 2005 and May 2015.

Results

Overall, 7354 patients were included among whom 1666 presented with neutropenia at ICU admission. Median ICU admission year was 2007 (IQR 2004–2010; range 1994–2012) and median number of admissions per year was 693 (IQR 450–1007). Overall mortality was 47.7%. ICU admission year was associated with a progressive decrease in hospital mortality (OR per year 0.94; 95% CI 0.93–0.95). After adjustment for confounders, year of ICU admission was independently associated with hospital mortality (OR for hospital mortality per year: 0.96; 95% CI 0.95–0.97). The association was also seen in patients with neutropenia but not in allogeneic stem cell transplant recipients.

Conclusion

After adjustment for patient characteristics, severity of illness and clustering, hospital mortality decreased steadily over time in critically ill oncology and hematology patients except for allogeneic stem cell transplant recipients.

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Titel: Changes in critically ill cancer patients’ short-term outcome over the last decades: results of systematic review with meta-analysis on individual data
verfasst von: Michaël Darmon
Aurélie Bourmaud
Quentin Georges
Marcio Soares
Kyeongman Jeon
Sandra Oeyen
Chin Kook Rhee
Pascale Gruber
Marlies Ostermann
Quentin A. Hill
Pieter Depuydt
Christelle Ferra
Anne-Claire Toffart
Peter Schellongowski
Alice Müller
Virginie Lemiale
Djamel Mokart
Elie Azoulay
Publikationsdatum: 29.05.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Intensive Care Medicine / Ausgabe 7/2019
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-019-05653-7

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Changes in critically ill cancer patients’ short-term outcome over the last decades: results of systematic review with meta-analysis on individual data

Abstract

Purpose

Methods

Datasource

Eligibility criteria

Results

Conclusion

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

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Abstract

Purpose

Methods

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Eligibility criteria

Results

Conclusion

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