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29.08.2020 | Original Communication

One-year survival of patients with high-grade glioma discharged alive from the intensive care unit

verfasst von: Maxens Decavèle, Nicolas Gatulle, Nicolas Weiss, Isabelle Rivals, Ahmed Idbaih, Sophie Demeret, Julien Mayaux, Martin Dres, Elise Morawiec, Khe Hoang-Xuan, Thomas Similowski, Alexandre Demoule

Erschienen in: Journal of Neurology | Ausgabe 2/2021

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Abstract

Introduction

Only limited data are available regarding the long-term prognosis of patients with high-grade glioma discharged alive from the intensive care unit. We sought to quantify 1-year mortality and evaluate the association between mortality and (1) functional status, and (2) management of anticancer therapy in patients with high-grade glioma discharged alive from the intensive care unit.

Patients and methods

Retrospective observational cohort study of patients with high-grade glioma admitted to two intensive care units between January 2009 and June 2018. Functional status was assessed by the Karnofsky Performance Status. Anticancer therapy after discharge was classified as (1) continued (unchanged), (2) modified (changed or stopped), or (3) initiated (for newly diagnosed disease).

Results

Ninety-one high-grade glioma patients (73% of whom had glioblastoma) were included and 78 (86%) of these patients were discharged alive from the intensive care unit. Anticancer therapy was continued, modified, and initiated in 41%, 42%, and 17% of patients, respectively. Corticosteroid therapy at the time of ICU admission [odds ratio (OR) 0.07] and cancer progression (OR 0.09) was independently associated with continuation of anticancer therapy. The mortality rate 1 year after ICU admission was 73%. On multivariate analysis, continuation of anticancer therapy (OR 0.18) and Karnofsky performance status on admission (OR 0.90) were independently associated with lower 1-year mortality.

Conclusion

The presence of high-grade glioma is not sufficient to justify refusal of intensive care unit admission. Performance status and continuation of anticancer therapy are associated with higher survival after intensive care unit discharge.

Previous presentation

Preliminary results were presented at the most recent congress of the French Intensive Care Society, Paris, 2019.

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Titel: One-year survival of patients with high-grade glioma discharged alive from the intensive care unit
verfasst von: Maxens Decavèle
Nicolas Gatulle
Nicolas Weiss
Isabelle Rivals
Ahmed Idbaih
Sophie Demeret
Julien Mayaux
Martin Dres
Elise Morawiec
Khe Hoang-Xuan
Thomas Similowski
Alexandre Demoule
Publikationsdatum: 29.08.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology / Ausgabe 2/2021
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-10191-0

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One-year survival of patients with high-grade glioma discharged alive from the intensive care unit

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Conclusion

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