García de Herreros Marta, Laguna Juan Carlos, Padrosa Joan, Barreto Tanny Daniela, Chicote Manoli, Font Carme, Grafiá Ignacio, Llavata Lucía, Seguí Elia, Tuca Albert, Viladot Margarita, Zamora-Martínez Carles, Fernández-Méndez Sara, Téllez Adrián, Nicolás Josep Maria, Prat Aleix, Castro-Rebollo Pedro, Marco-Hernández Javier
Medical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain.
Translational Genomics and Targeted Therapies in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain.
Diagnostics (Basel). 2024 Mar 29;14(7):730. doi: 10.3390/diagnostics14070730.
Despite the increasing number of ICU admissions among patients with solid tumours, there is a lack of tools with which to identify patients who may benefit from critical support. We aim to characterize the clinical profile and outcomes of patients with solid malignancies admitted to the ICU.
Retrospective observational study of patients with cancer non-electively admitted to the ICU of the Hospital Clinic of Barcelona (Spain) between January 2019 and December 2019. Data regarding patient and neoplasm characteristics, ICU admission features and outcomes were collected from medical records.
97 ICU admissions of 84 patients were analysed. Lung cancer (22.6%) was the most frequent neoplasm. Most of the patients had metastatic disease (79.5%) and were receiving oncological treatment (75%). The main reason for ICU admission was respiratory failure (38%). Intra-ICU and in-hospital mortality rates were 9.4% and 24%, respectively. Mortality rates at 1, 3 and 6 months were 19.6%, 36.1% and 53.6%. Liver metastasis, gastrointestinal cancer, hypoalbuminemia, elevated basal C-reactive protein, ECOG-PS greater than 2 at ICU admission, admission from ward and an APACHE II score over 14 were related to higher mortality. Functional status was severely affected at discharge, and oncological treatment was definitively discontinued in 40% of the patients.
Medium-term mortality and functional deterioration of patients with solid cancers non-electively admitted to the ICU are high. Surrogate markers of cachexia, liver metastasis and poor ECOG-PS at ICU admission are risk factors for mortality.
尽管实体瘤患者入住重症监护病房（ICU）的人数不断增加，但缺乏能够识别可能从重症支持中获益的患者的工具。我们旨在描述入住ICU的实体恶性肿瘤患者的临床特征和预后。
对2019年1月至2019年12月间非选择性入住西班牙巴塞罗那医院诊所ICU的癌症患者进行回顾性观察研究。从病历中收集有关患者和肿瘤特征、ICU入院特征及预后的数据。
分析了84例患者的97次ICU入院情况。肺癌（22.6%）是最常见的肿瘤。大多数患者有转移性疾病（79.5%）且正在接受肿瘤治疗（75%）。入住ICU的主要原因是呼吸衰竭（38%）。ICU内死亡率和住院死亡率分别为9.4%和24%。1个月、3个月和6个月时的死亡率分别为19.6%、36.1%和53.6%。肝转移、胃肠道癌、低白蛋白血症、基础C反应蛋白升高、入住ICU时东部肿瘤协作组（ECOG）体能状态评分大于2、从病房转入及急性生理与慢性健康状况评分系统（APACHE II）评分超过14与较高死亡率相关。出院时功能状态受到严重影响，40%的患者最终停止了肿瘤治疗。
非选择性入住ICU的实体癌患者的中期死亡率和功能恶化率较高。恶病质、肝转移的替代标志物以及入住ICU时ECOG体能状态较差是死亡的危险因素。
