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食管癌重症监护病房的结局及预后因素:一项在中国癌症专科医院开展的横断面研究。

Intensive care unit outcomes and prognostic factors of esophageal cancer: A cross-sectional study in Chinese cancer-specialized hospitals.

作者信息

Tang Jiang-Feng, Xia Rui, Xing Xue-Zhong, Wang Chang-Song, Ma Gang, Wang Hong-Zhi, Zhu Biao, Zhao Jiang-Hong, Zhou Dong-Min, Zhang Li, Huang Ming-Guang, Quan Rong-Xi, Ye Yong, Zhang Guo-Xing, Jiang Zheng-Ying, Huang Bing, Xu Shan-Ling, Xiao Yun, Zhang Lin-Lin, Lin Rui-Yun, Ma Shu-Liang, Qiu Yu-An, Zheng Zhen, Sun Ni, Xian Le-Wu, Li Ji, Zhang Ming, Guo Zhi-Jun, Tao Yong, Zhou Xiang-Zhe, Chen Wei, Wang Dao-Xie, Chi Ji-Yan, Wang Dong-Hao, Liu Kai-Zhong

机构信息

Department of Intensive Care Unit, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine, Chinese Academy of Sciences, Hangzhou 310000, Zhejiang Province, China.

Department of Intensive Care Unit, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300000, China.

出版信息

World J Gastrointest Oncol. 2025 Aug 15;17(8):106688. doi: 10.4251/wjgo.v17.i8.106688.

Abstract

BACKGROUND

Esophageal cancer patients had the highest intensive care unit (ICU) admitted rate in cancer patients. But their prognosis and evaluation methods were rarely studied.

AIM

To depict the short-term mortality outcome and identify the potential prognostic factors of esophageal cancer patients admitted into ICU.

METHODS

A multicenter cross-sectional study was performed from May 10, 2021 to July 10, 2021 at ICU departments of 37 cancer specialized hospitals in China. Patients aged ≥ 14 years with ICU duration ≥ 24 hours were included. Clinical records of patients with primary esophageal cancer diagnosis were reviewed. Patients were separated into groups according to the 90 days survival. Characteristics between groups were compared. Single and multi-variate regression tests were applied to analyze the correlated factors of ICU outcomes. Predictive values of disease severity scores were assessed using receiver operating characteristic curve analysis.

RESULTS

Total 180 esophageal cancer patients were included. The 90 days mortality was 22.2%. Patients with mortality outcome showed differences from those survived mostly in disease severity and unplanned transfer from clinical ward. The current evaluation tools, including Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation II scores had low accuracy in prediction of short-term death. ICU admitted esophageal cancer patients have poor prognosis, especially those with acute illness.

CONCLUSION

The prognostic tools for these patients need to be further optimized.

摘要

背景

食管癌患者在癌症患者中重症监护病房(ICU)收治率最高。但其预后及评估方法鲜少被研究。

目的

描述食管癌患者入住ICU的短期死亡结局并确定潜在的预后因素。

方法

2021年5月10日至2021年7月10日在中国37家肿瘤专科医院的ICU科室进行了一项多中心横断面研究。纳入年龄≥14岁、ICU住院时间≥24小时的患者。回顾原发性食管癌诊断患者的临床记录。根据90天生存率将患者分组。比较组间特征。应用单因素和多因素回归检验分析ICU结局的相关因素。使用受试者工作特征曲线分析评估疾病严重程度评分的预测价值。

结果

共纳入180例食管癌患者。90天死亡率为22.2%。死亡患者与存活患者在疾病严重程度和从临床病房的非计划转院方面大多存在差异。当前的评估工具,包括序贯器官衰竭评估和急性生理与慢性健康状况评估II评分,对短期死亡的预测准确性较低。入住ICU的食管癌患者预后较差,尤其是那些患有急性疾病的患者。

结论

这些患者的预后评估工具需要进一步优化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6808/12362544/0237688ec074/wjgo-17-8-106688-g001.jpg

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