Characterisation and Outcomes of Patients with Solid Organ Malignancies Admitted to the Intensive Care Unit: Mortality and Impact on Functional Status and Oncological Treatment
Background: 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...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/14/7/730 |
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| author | Marta García de Herreros Juan Carlos Laguna Joan Padrosa Tanny Daniela Barreto Manoli Chicote Carme Font Ignacio Grafiá Lucía Llavata Elia Seguí Albert Tuca Margarita Viladot Carles Zamora-Martínez Sara Fernández-Méndez Adrián Téllez Josep Maria Nicolás Aleix Prat Pedro Castro-Rebollo Javier Marco-Hernández |
| author_facet | Marta García de Herreros Juan Carlos Laguna Joan Padrosa Tanny Daniela Barreto Manoli Chicote Carme Font Ignacio Grafiá Lucía Llavata Elia Seguí Albert Tuca Margarita Viladot Carles Zamora-Martínez Sara Fernández-Méndez Adrián Téllez Josep Maria Nicolás Aleix Prat Pedro Castro-Rebollo Javier Marco-Hernández |
| author_sort | Marta García de Herreros |
| collection | DOAJ |
| description | Background: 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. Methods: 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. Results: 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. Conclusion: 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. |
| first_indexed | 2024-04-24T10:47:58Z |
| format | Article |
| id | doaj.art-91c39e44da654bef8ae8199d15523abb |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-04-24T10:47:58Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-91c39e44da654bef8ae8199d15523abb2024-04-12T13:16:48ZengMDPI AGDiagnostics2075-44182024-03-0114773010.3390/diagnostics14070730Characterisation and Outcomes of Patients with Solid Organ Malignancies Admitted to the Intensive Care Unit: Mortality and Impact on Functional Status and Oncological TreatmentMarta García de Herreros0Juan Carlos Laguna1Joan Padrosa2Tanny Daniela Barreto3Manoli Chicote4Carme Font5Ignacio Grafiá6Lucía Llavata7Elia Seguí8Albert Tuca9Margarita Viladot10Carles Zamora-Martínez11Sara Fernández-Méndez12Adrián Téllez13Josep Maria Nicolás14Aleix Prat15Pedro Castro-Rebollo16Javier Marco-Hernández17Medical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, SpainMedical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, SpainMedical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, SpainRadiation Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, SpainMedical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, SpainMedical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, SpainMedical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, SpainMedical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, SpainMedical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, SpainMedical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, SpainMedical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, SpainMedical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, SpainMedical Intensive Care Unit, Internal Medicine Department Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, SpainMedical Intensive Care Unit, Internal Medicine Department Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, SpainMedical Intensive Care Unit, Internal Medicine Department Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, SpainMedical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, SpainMedical Intensive Care Unit, Internal Medicine Department Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, SpainMedical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, SpainBackground: 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. Methods: 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. Results: 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. Conclusion: 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.https://www.mdpi.com/2075-4418/14/7/730neoplasmscritical careprognosisintensive care unithospital mortalityhypoalbuminemia |
| spellingShingle | Marta García de Herreros Juan Carlos Laguna Joan Padrosa Tanny Daniela Barreto Manoli Chicote Carme Font Ignacio Grafiá Lucía Llavata Elia Seguí Albert Tuca Margarita Viladot Carles Zamora-Martínez Sara Fernández-Méndez Adrián Téllez Josep Maria Nicolás Aleix Prat Pedro Castro-Rebollo Javier Marco-Hernández Characterisation and Outcomes of Patients with Solid Organ Malignancies Admitted to the Intensive Care Unit: Mortality and Impact on Functional Status and Oncological Treatment Diagnostics neoplasms critical care prognosis intensive care unit hospital mortality hypoalbuminemia |
| title | Characterisation and Outcomes of Patients with Solid Organ Malignancies Admitted to the Intensive Care Unit: Mortality and Impact on Functional Status and Oncological Treatment |
| title_full | Characterisation and Outcomes of Patients with Solid Organ Malignancies Admitted to the Intensive Care Unit: Mortality and Impact on Functional Status and Oncological Treatment |
| title_fullStr | Characterisation and Outcomes of Patients with Solid Organ Malignancies Admitted to the Intensive Care Unit: Mortality and Impact on Functional Status and Oncological Treatment |
| title_full_unstemmed | Characterisation and Outcomes of Patients with Solid Organ Malignancies Admitted to the Intensive Care Unit: Mortality and Impact on Functional Status and Oncological Treatment |
| title_short | Characterisation and Outcomes of Patients with Solid Organ Malignancies Admitted to the Intensive Care Unit: Mortality and Impact on Functional Status and Oncological Treatment |
| title_sort | characterisation and outcomes of patients with solid organ malignancies admitted to the intensive care unit mortality and impact on functional status and oncological treatment |
| topic | neoplasms critical care prognosis intensive care unit hospital mortality hypoalbuminemia |
| url | https://www.mdpi.com/2075-4418/14/7/730 |
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