Institute for Advanced Biosciences INSERM U1209 CNRS UMR5309, Grenoble Alpes University, Grenoble, France.
Department of Pneumology and Physiology, Grenoble Alpes University, Grenoble, France.
PLoS One. 2023 Jan 5;18(1):e0280027. doi: 10.1371/journal.pone.0280027. eCollection 2023.
Although short- and long-term survival in critically ill patients with cancer has been described, data on their quality of life (QoL) after an intensive care unit (ICU) stay are scarce. This study aimed to determine the impact of an ICU stay on QoL assessed at 3 months in patients with solid malignancies.
A prospective case-control study was conducted in three French ICUs between February 2020 and February 2021. Adult patients with lung, colorectal, or head and neck cancer who were admitted in the ICU were matched in a 1:2 ratio with patients who were not admitted in the ICU regarding their type of cancer, curative or palliative anticancer treatment, and treatment line. The primary endpoint was the QoL assessed at 3 months from inclusion using the mental and physical components of the Short Form 36 (SF-36) Health Survey. The use of anticancer therapies at 3 months was also evaluated.
In total, 23 surviving ICU cancer patients were matched with 46 non-ICU cancer patients. Four patients in the ICU group did not respond to the questionnaire. The mental component score of the SF-36 was higher in ICU patients than in non-ICU patients: median of 54 (interquartile range: 42-57) vs. 47 (37-52), respectively (p = 0.01). The physical component score of the SF-36 did not differ between groups: 35 (31-47) vs. 42 (34-47) (p = 0.24). In multivariate analysis, no association was found between patient QoL and an ICU stay. A good performance status and a non-metastatic cancer at baseline were independently associated with a higher physical component score. The use of anticancer therapies at 3 months was comparable between the two groups.
In patients with solid malignancies, an ICU stay had no negative impact on QoL at 3 months after discharge when compared with matched non-ICU patients.
尽管已经描述了危重症癌症患者的短期和长期生存情况,但关于他们在重症监护病房(ICU)停留后生活质量(QoL)的数据却很少。本研究旨在确定 ICU 停留对 3 个月时患有实体恶性肿瘤患者 QoL 的影响。
这是一项在 2020 年 2 月至 2021 年 2 月期间在法国的三个 ICU 进行的前瞻性病例对照研究。纳入的 ICU 成人患者患有肺癌、结直肠癌或头颈部癌症,与未入住 ICU 的患者进行匹配,匹配因素包括癌症类型、癌症的治愈或姑息性治疗以及治疗线。主要终点是通过使用 36 项简短健康调查(SF-36)的心理和生理成分评估的从纳入开始 3 个月时的 QoL。还评估了 3 个月时的抗癌治疗的使用情况。
共有 23 名存活的 ICU 癌症患者与 46 名非 ICU 癌症患者相匹配。ICU 组中有 4 名患者未回复问卷。SF-36 的心理成分评分在 ICU 患者中高于非 ICU 患者:中位数分别为 54(四分位距:42-57)和 47(37-52)(p = 0.01)。两组的 SF-36 生理成分评分无差异:分别为 35(31-47)和 42(34-47)(p = 0.24)。多变量分析表明,患者 QoL 与 ICU 停留之间没有关联。基线时较好的体能状态和非转移性癌症与较高的生理成分评分独立相关。两组在 3 个月时的抗癌治疗使用情况相似。
与匹配的非 ICU 患者相比,在患有实体恶性肿瘤的患者中,与 ICU 停留相比,在出院后 3 个月时 QoL 没有受到负面影响。