Critically ill metastatic cancer patients returning home after unplanned ICU stay: an observational, multicentre retrospective study
Abstract Background Data about critically ill metastatic cancer patients functional outcome after unplanned admission to the ICU are scarce. The aim of this study was to assess factors associated with 90-day return home and 1-year survival in this population. Study design and methods A multicenter r...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-08-01
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| Series: | Annals of Intensive Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13613-023-01170-5 |
| _version_ | 1827633158537871360 |
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| author | Frédéric Gonzalez Rémi Starka Laurent Ducros Magali Bisbal Laurent Chow-Chine Luca Servan Jean-Manuel de Guibert Bruno Pastene Marion Faucher Antoine Sannini Marc Leone Djamel Mokart |
| author_facet | Frédéric Gonzalez Rémi Starka Laurent Ducros Magali Bisbal Laurent Chow-Chine Luca Servan Jean-Manuel de Guibert Bruno Pastene Marion Faucher Antoine Sannini Marc Leone Djamel Mokart |
| author_sort | Frédéric Gonzalez |
| collection | DOAJ |
| description | Abstract Background Data about critically ill metastatic cancer patients functional outcome after unplanned admission to the ICU are scarce. The aim of this study was to assess factors associated with 90-day return home and 1-year survival in this population. Study design and methods A multicenter retrospective study included all consecutive metastatic cancer patients admitted to the ICU for unplanned reason between 2017 and 2020. Results Among 253 included metastatic cancer patients, mainly with lung cancer, 94 patients (37.2%) could return home on day 90. One-year survival rate was 28.5%. Performance status 0 or 1 (OR, 2.18; 95% CI 1.21–3.93; P = 0.010), no malnutrition (OR, 2.90; 95% CI 1.61–5.24; P < 0.001), female gender (OR, 2.39; 95% CI 1.33–4.29; P = 0.004), recent chemotherapy (OR, 2.62; 95% CI 1.40–4.90; P = 0.003), SOFA score ≤ 5 on admission (OR, 2.62; 95% CI 1.41–4.90; P = 0.002) were significantly predictive for 90-day return home. Malnutrition (HR, 1.66; 95% CI 1.18–2.22; P = 0.003), acute respiratory failure (ARF) as reason for admission (HR, 1.40; 95% CI 1.10–1.95; P = 0.043), SAPS II on admission (HR, 1.03; 95% CI 1.02–1.05; P < 0.001) and decisions to forgo life-sustaining therapies (DFLST) (HR, 2.80; 95% CI 2.04–3.84; P < 0.001) were independently associated with 1-year mortality. Conclusions More than one out of three metastatic cancer patients could return home within 3 months after an unplanned admission to the ICU. Previous performance and nutritional status, ongoing specific treatment and low severity of the acute illness were found to be predictive for return home. Such encouraging findings should help change the dismal perception of critically ill metastatic cancer patients. |
| first_indexed | 2024-03-09T14:55:39Z |
| format | Article |
| id | doaj.art-df52f8be27454417bc58db9707894ac6 |
| institution | Directory Open Access Journal |
| issn | 2110-5820 |
| language | English |
| last_indexed | 2024-03-09T14:55:39Z |
| publishDate | 2023-08-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Intensive Care |
| spelling | doaj.art-df52f8be27454417bc58db9707894ac62023-11-26T14:13:11ZengSpringerOpenAnnals of Intensive Care2110-58202023-08-0113111110.1186/s13613-023-01170-5Critically ill metastatic cancer patients returning home after unplanned ICU stay: an observational, multicentre retrospective studyFrédéric Gonzalez0Rémi Starka1Laurent Ducros2Magali Bisbal3Laurent Chow-Chine4Luca Servan5Jean-Manuel de Guibert6Bruno Pastene7Marion Faucher8Antoine Sannini9Marc Leone10Djamel Mokart11Polyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli-CalmettesPolyvalent Intensive Care Unit, Sainte Musse HospitalPolyvalent Intensive Care Unit, Sainte Musse HospitalPolyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli-CalmettesPolyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli-CalmettesPolyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli-CalmettesPolyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli-CalmettesDepartment of Anesthesiology and Intensive Care Unit, Nord Hospital, Assistance Publique Hôpitaux Universitaire de Marseille, Aix Marseille UniversityPolyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli-CalmettesPolyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli-CalmettesDepartment of Anesthesiology and Intensive Care Unit, Nord Hospital, Assistance Publique Hôpitaux Universitaire de Marseille, Aix Marseille UniversityPolyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli-CalmettesAbstract Background Data about critically ill metastatic cancer patients functional outcome after unplanned admission to the ICU are scarce. The aim of this study was to assess factors associated with 90-day return home and 1-year survival in this population. Study design and methods A multicenter retrospective study included all consecutive metastatic cancer patients admitted to the ICU for unplanned reason between 2017 and 2020. Results Among 253 included metastatic cancer patients, mainly with lung cancer, 94 patients (37.2%) could return home on day 90. One-year survival rate was 28.5%. Performance status 0 or 1 (OR, 2.18; 95% CI 1.21–3.93; P = 0.010), no malnutrition (OR, 2.90; 95% CI 1.61–5.24; P < 0.001), female gender (OR, 2.39; 95% CI 1.33–4.29; P = 0.004), recent chemotherapy (OR, 2.62; 95% CI 1.40–4.90; P = 0.003), SOFA score ≤ 5 on admission (OR, 2.62; 95% CI 1.41–4.90; P = 0.002) were significantly predictive for 90-day return home. Malnutrition (HR, 1.66; 95% CI 1.18–2.22; P = 0.003), acute respiratory failure (ARF) as reason for admission (HR, 1.40; 95% CI 1.10–1.95; P = 0.043), SAPS II on admission (HR, 1.03; 95% CI 1.02–1.05; P < 0.001) and decisions to forgo life-sustaining therapies (DFLST) (HR, 2.80; 95% CI 2.04–3.84; P < 0.001) were independently associated with 1-year mortality. Conclusions More than one out of three metastatic cancer patients could return home within 3 months after an unplanned admission to the ICU. Previous performance and nutritional status, ongoing specific treatment and low severity of the acute illness were found to be predictive for return home. Such encouraging findings should help change the dismal perception of critically ill metastatic cancer patients.https://doi.org/10.1186/s13613-023-01170-5ICUMetastatic cancerQuality of lifeTriage90-Day return home |
| spellingShingle | Frédéric Gonzalez Rémi Starka Laurent Ducros Magali Bisbal Laurent Chow-Chine Luca Servan Jean-Manuel de Guibert Bruno Pastene Marion Faucher Antoine Sannini Marc Leone Djamel Mokart Critically ill metastatic cancer patients returning home after unplanned ICU stay: an observational, multicentre retrospective study Annals of Intensive Care ICU Metastatic cancer Quality of life Triage 90-Day return home |
| title | Critically ill metastatic cancer patients returning home after unplanned ICU stay: an observational, multicentre retrospective study |
| title_full | Critically ill metastatic cancer patients returning home after unplanned ICU stay: an observational, multicentre retrospective study |
| title_fullStr | Critically ill metastatic cancer patients returning home after unplanned ICU stay: an observational, multicentre retrospective study |
| title_full_unstemmed | Critically ill metastatic cancer patients returning home after unplanned ICU stay: an observational, multicentre retrospective study |
| title_short | Critically ill metastatic cancer patients returning home after unplanned ICU stay: an observational, multicentre retrospective study |
| title_sort | critically ill metastatic cancer patients returning home after unplanned icu stay an observational multicentre retrospective study |
| topic | ICU Metastatic cancer Quality of life Triage 90-Day return home |
| url | https://doi.org/10.1186/s13613-023-01170-5 |
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