Factors associated with survival of patients with solid Cancer alive after intensive care unit discharge between 2005 and 2013
Abstract Background At intensive care unit (ICU) admission, the issue about prognosis of critically ill cancer patients is of clinical interest, especially after ICU discharge. Our objective was to assess the factors associated with 3- and 6-month survival of ICU cancer survivors. Methods Based on t...
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doaj-23d096cb2926455eaaa36ec28621f3182021-01-10T12:59:32ZengBMCBMC Cancer1471-24072021-01-0121111010.1186/s12885-020-07706-3Factors associated with survival of patients with solid Cancer alive after intensive care unit discharge between 2005 and 2013Hubert Gheerbrant0Jean-François Timsit1Nicolas Terzi2Stéphane Ruckly3Mathieu Laramas4Matteo Giaj Levra5Emmanuelle Jacquet6Loic Falque7Denis Moro-Sibilot8Anne-Claire Toffart9Department of Pneumology and Physiology, Grenoble-Alpes University HospitalMedical and Infectious Diseases ICU, APHPDepartment of Intensive Care and Reanimation, Grenoble-Alpes University HospitalDepartment of Biostatistics, OUTCOMEREA™Cancer and Blood Diseases, Grenoble-Alpes University HospitalDepartment of Pneumology and Physiology, Grenoble-Alpes University HospitalCancer and Blood Diseases, Grenoble-Alpes University HospitalDepartment of Pneumology and Physiology, Grenoble-Alpes University HospitalDepartment of Pneumology and Physiology, Grenoble-Alpes University HospitalDepartment of Pneumology and Physiology, Grenoble-Alpes University HospitalAbstract Background At intensive care unit (ICU) admission, the issue about prognosis of critically ill cancer patients is of clinical interest, especially after ICU discharge. Our objective was to assess the factors associated with 3- and 6-month survival of ICU cancer survivors. Methods Based on the French OutcomeRea™ database, we included solid cancer patients discharged alive, between December 2005 and November 2013, from the medical ICU of the university hospital in Grenoble, France. Patient characteristics and outcome at 3 and 6 months following ICU discharge were extracted from available database. Results Of the 361 cancer patients with unscheduled admissions, 253 (70%) were discharged alive from ICU. The main primary cancer sites were digestive (31%) and thoracic (26%). The 3- and 6-month mortality rates were 33 and 41%, respectively. Factors independently associated with 6-month mortality included ECOG performance status (ECOG-PS) of 3–4 (OR,3.74; 95%CI: 1.67–8.37), metastatic disease (OR,2.56; 95%CI: 1.34–4.90), admission for cancer progression (OR,2.31; 95%CI: 1.14–4.68), SAPS II of 45 to 58 (OR,4.19; 95%CI: 1.76–9.97), and treatment limitation decision at ICU admission (OR,4.00; 95%CI: 1.64–9.77). Interestingly, previous cancer chemotherapy prior to ICU admission was independently associated with lower 3-month mortality (OR, 0.38; 95%CI: 0.19–0.75). Among patients with an ECOG-PS 0–1 at admission, 70% (n = 66) and 61% (n = 57) displayed an ECOG-PS 0–2 at 3- and 6-months, respectively. At 3 months, 74 (55%) patients received anticancer treatment, 13 (8%) were given exclusive palliative care. Conclusions Factors associated with 6-month mortality are almost the same as those known to be associated with ICU mortality. We highlight that most patients recovered an ECOG-PS of 0–2 at 3 and 6 months, in particular those with a good ECOG-PS at ICU admission and could benefit from an anticancer treatment following ICU discharge.https://doi.org/10.1186/s12885-020-07706-3Solid cancerIntensive care unitPrognosisAnticancer treatmentsPerformance statusSurvival |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hubert Gheerbrant Jean-François Timsit Nicolas Terzi Stéphane Ruckly Mathieu Laramas Matteo Giaj Levra Emmanuelle Jacquet Loic Falque Denis Moro-Sibilot Anne-Claire Toffart |
spellingShingle |
Hubert Gheerbrant Jean-François Timsit Nicolas Terzi Stéphane Ruckly Mathieu Laramas Matteo Giaj Levra Emmanuelle Jacquet Loic Falque Denis Moro-Sibilot Anne-Claire Toffart Factors associated with survival of patients with solid Cancer alive after intensive care unit discharge between 2005 and 2013 BMC Cancer Solid cancer Intensive care unit Prognosis Anticancer treatments Performance status Survival |
author_facet |
Hubert Gheerbrant Jean-François Timsit Nicolas Terzi Stéphane Ruckly Mathieu Laramas Matteo Giaj Levra Emmanuelle Jacquet Loic Falque Denis Moro-Sibilot Anne-Claire Toffart |
author_sort |
Hubert Gheerbrant |
title |
Factors associated with survival of patients with solid Cancer alive after intensive care unit discharge between 2005 and 2013 |
title_short |
Factors associated with survival of patients with solid Cancer alive after intensive care unit discharge between 2005 and 2013 |
title_full |
Factors associated with survival of patients with solid Cancer alive after intensive care unit discharge between 2005 and 2013 |
title_fullStr |
Factors associated with survival of patients with solid Cancer alive after intensive care unit discharge between 2005 and 2013 |
title_full_unstemmed |
Factors associated with survival of patients with solid Cancer alive after intensive care unit discharge between 2005 and 2013 |
title_sort |
factors associated with survival of patients with solid cancer alive after intensive care unit discharge between 2005 and 2013 |
publisher |
BMC |
series |
BMC Cancer |
issn |
1471-2407 |
publishDate |
2021-01-01 |
description |
Abstract Background At intensive care unit (ICU) admission, the issue about prognosis of critically ill cancer patients is of clinical interest, especially after ICU discharge. Our objective was to assess the factors associated with 3- and 6-month survival of ICU cancer survivors. Methods Based on the French OutcomeRea™ database, we included solid cancer patients discharged alive, between December 2005 and November 2013, from the medical ICU of the university hospital in Grenoble, France. Patient characteristics and outcome at 3 and 6 months following ICU discharge were extracted from available database. Results Of the 361 cancer patients with unscheduled admissions, 253 (70%) were discharged alive from ICU. The main primary cancer sites were digestive (31%) and thoracic (26%). The 3- and 6-month mortality rates were 33 and 41%, respectively. Factors independently associated with 6-month mortality included ECOG performance status (ECOG-PS) of 3–4 (OR,3.74; 95%CI: 1.67–8.37), metastatic disease (OR,2.56; 95%CI: 1.34–4.90), admission for cancer progression (OR,2.31; 95%CI: 1.14–4.68), SAPS II of 45 to 58 (OR,4.19; 95%CI: 1.76–9.97), and treatment limitation decision at ICU admission (OR,4.00; 95%CI: 1.64–9.77). Interestingly, previous cancer chemotherapy prior to ICU admission was independently associated with lower 3-month mortality (OR, 0.38; 95%CI: 0.19–0.75). Among patients with an ECOG-PS 0–1 at admission, 70% (n = 66) and 61% (n = 57) displayed an ECOG-PS 0–2 at 3- and 6-months, respectively. At 3 months, 74 (55%) patients received anticancer treatment, 13 (8%) were given exclusive palliative care. Conclusions Factors associated with 6-month mortality are almost the same as those known to be associated with ICU mortality. We highlight that most patients recovered an ECOG-PS of 0–2 at 3 and 6 months, in particular those with a good ECOG-PS at ICU admission and could benefit from an anticancer treatment following ICU discharge. |
topic |
Solid cancer Intensive care unit Prognosis Anticancer treatments Performance status Survival |
url |
https://doi.org/10.1186/s12885-020-07706-3 |
work_keys_str_mv |
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