Moen Martine Kjølberg, Løhre Erik Torbjørn, Jakobsen Gunnhild, Thronæs Morten, Klepstad Pål
Clinic of Anaesthesia and Intensive Care, St. Olav's University Hospital, 7030 Trondheim, Norway.
Cancer Clinic, St. Olav's University Hospital, 7030 Trondheim, Norway.
Cancers (Basel). 2022 Mar 22;14(7):1602. doi: 10.3390/cancers14071602.
Decision-making for antibiotic therapy in palliative cancer care implies avoiding futile interventions and to identify patients who benefit from treatment. We evaluated patient-reported outcome-measures (PROMs), physiological findings, and survival in palliative cancer care patients hospitalized with an infection. All acute admissions during one year, directly to a University Hospital unit that provided integrated services, were included. Serious infection was defined as a need to start intravenous antibiotics. PROMs, clinical and paraclinical variables, and survival were obtained. Sixty-two of 257 patients received intravenous antibiotic treatment. PROMs were generally similar in the infection group and the non-infection group, both in respect to intensities at admission and improvements during the stay. There were more physiological and paraclinical deviations at admission in patients in the infection group. These deviations improved during the stay. Survival was not poorer in the infection group compared to the non-infection group. Patients in integrated cancer care were as likely to be put on intravenous antibiotics but had longer survival. In integrated oncology and palliative cancer services, patients with an infection had similar outcomes as those without an infection. This argues that the use of intravenous antibiotics is appropriate in many patients admitted to palliative care.
姑息性癌症护理中抗生素治疗的决策意味着避免无效干预，并识别能从治疗中获益的患者。我们评估了因感染住院的姑息性癌症护理患者的患者报告结局指标（PROMs）、生理检查结果和生存率。纳入了一年内直接入住提供综合服务的大学医院科室的所有急性入院患者。严重感染定义为需要开始静脉使用抗生素。获取了PROMs、临床和辅助临床变量以及生存率。257名患者中有62名接受了静脉抗生素治疗。感染组和非感染组的PROMs在入院时的强度和住院期间的改善方面总体相似。感染组患者入院时的生理和辅助临床偏差更多。这些偏差在住院期间有所改善。与非感染组相比，感染组的生存率并不更低。综合癌症护理中的患者接受静脉抗生素治疗的可能性相同，但生存期更长。在综合肿瘤学和姑息性癌症服务中，感染患者与未感染患者的结局相似。这表明在许多入住姑息治疗的患者中使用静脉抗生素是合适的。
