Bos Monique M E M, Verburg Ilona W M, Dumaij Ineke, Stouthard Jacqueline, Nortier Johannes W R, Richel Dick, van der Zwan Eric P A, de Keizer Nicolette F, de Jonge Evert
Department of Medicine, Reinier de Graaf Hospital, Delft, The Netherlands.
Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Cancer Med. 2015 Jul;4(7):966-76. doi: 10.1002/cam4.430. Epub 2015 Apr 18.
The aim of this study was to obtain insight into which proportion of cancer patients is admitted to an Intensive Care Unit (ICU) and how their survival, demographic, and clinical characteristics relate to cancer patients not admitted to the ICU. Data from patients registered with cancer between 2006 and 2011 in four hospitals in the Netherlands were linked to the Dutch National Intensive Care Evaluation registry. About 36,860 patients with cancer were identified, of whom 2,374 (6.4%) were admitted to the ICU. Fifty-six percent of ICU admissions were after surgery, whereas 44% were for medical reasons. The risk for ICU admission was highest among cancer patients treated with surgery either alone or combined with chemotherapy and/or radiation therapy. Only 80 of 1,073 medical ICU admissions (3.3%) were for cancer-specific reasons. Although more women (54.0%) than men were registered with cancer, the proportion of male cancer patients admitted to an ICU was much higher (9.3 vs. 4.0%, P < 0.001). Five-year survival of cancer patients admitted to the ICU was substantial (41%) although median survival was much lower (1,104 days) than in patients not admitted to the ICU (median survival time not reached, P < 0.001). These results show that one out of 16 cancer patients was admitted to an ICU and that ICU support for this group should not be considered futile.
本研究的目的是深入了解癌症患者入住重症监护病房（ICU）的比例，以及他们的生存情况、人口统计学特征和临床特征与未入住ICU的癌症患者之间的关系。荷兰四家医院2006年至2011年登记的癌症患者数据与荷兰国家重症监护评估登记处相关联。共识别出约36,860例癌症患者，其中2,374例（6.4%）入住了ICU。入住ICU的患者中，56%是在手术后入住，而44%是由于医疗原因。在仅接受手术或接受手术联合化疗和/或放疗的癌症患者中，入住ICU的风险最高。在1,073例入住医疗ICU的患者中，只有80例（3.3%）是由于癌症相关原因。尽管登记的癌症女性患者（54.0%）多于男性，但男性癌症患者入住ICU的比例要高得多（9.3%对4.0%，P<0.001）。入住ICU的癌症患者5年生存率可观（41%），尽管中位生存期（1,104天）远低于未入住ICU的患者（中位生存时间未达到，P<0.001）。这些结果表明，每16例癌症患者中有1例入住ICU，对这一群体的ICU支持不应被视为徒劳。
