The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 401 North Broadway, Weinberg Building #1370, Baltimore, MD 21231, USA.
Crit Care Clin. 2010 Jan;26(1):1-20. doi: 10.1016/j.ccc.2009.10.003.
Critical care for patients with cancer was once considered inappropriate because of a perceived poor prognosis for their long-term survival. Three decades of research has yielded evidence to support the use of critical care resources for many patients with cancer. A methodical approach to triage and evaluation of critically ill patients regardless of baseline medical diagnosis, coupled with an appreciation for the likely prognosis of their current cancer, is most likely to yield the fairest and most accurate appropriation of care. No clinical scoring system has emerged that accurately defines the severity of illness and likelihood for survival in patients with cancer. This article reviews the studies that have attempted to apply mortality prediction scales or scoring systems to these patients. Clinical judgment with incorporation of consensus opinions from the literature should be used to develop admission or restriction criteria for intensive care of patients with cancer.
对癌症患者的重症监护曾被认为是不适当的，因为人们认为他们的长期生存预后较差。三十年来的研究提供了证据，支持对许多癌症患者使用重症监护资源。无论基线医疗诊断如何，对重症患者进行分诊和评估的系统方法，加上对当前癌症预后的了解，最有可能公平、准确地分配护理资源。目前还没有出现一种临床评分系统能够准确定义癌症患者的疾病严重程度和生存可能性。本文回顾了试图将死亡率预测量表或评分系统应用于这些患者的研究。应结合文献中的共识意见，运用临床判断来制定癌症患者进入或限制重症监护的标准。
