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Erschienen in:

01.09.2012 | Original

Early intervention on the outcomes in critically ill cancer patients admitted to intensive care units

verfasst von: 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

Erschienen in: Intensive Care Medicine | Ausgabe 9/2012

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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.

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Titel: Early intervention on the outcomes in critically ill cancer patients admitted to intensive care units
verfasst von: 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
Publikationsdatum: 01.09.2012
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 9/2012
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-012-2594-0

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Early intervention on the outcomes in critically ill cancer patients admitted to intensive care units