Is aggressive care appropriate for patients with cancer complicated by pneumonia? A retrospective chart review in a tertiary hospital
Abstract Background Pneumonia in cancer patients is often problematic in order to decide whether to admit and administer antibiotics or pursue a comfort care pathway that may avoid in-hospital death. We aimed to identify factors which are easily assessed at admission in Thailand’s healthcare context...
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| Format: | Article |
| Language: | English |
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BMC
2023-01-01
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| Series: | BMC Palliative Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12904-023-01127-2 |
| _version_ | 1797958444217532416 |
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| author | Chanchanok Aramrat Thawalrat Ratanasiri Patama Gomutbutra |
| author_facet | Chanchanok Aramrat Thawalrat Ratanasiri Patama Gomutbutra |
| author_sort | Chanchanok Aramrat |
| collection | DOAJ |
| description | Abstract Background Pneumonia in cancer patients is often problematic in order to decide whether to admit and administer antibiotics or pursue a comfort care pathway that may avoid in-hospital death. We aimed to identify factors which are easily assessed at admission in Thailand’s healthcare context that could serve as prognostic factors for in-hospital death. Methods Regression analysis was utilized to identify the prognostic factors from clinical factors collected at admission. The primary outcome was in-hospital death. Data was collected from the electronic medical records of Chiang Mai University Hospital, Thailand, from 2016 to 2017. Data on adult cancer patients admitted due to pneumonia were reviewed. Results In total, 245 patients were included, and 146 (59.6%) were male. The median age of the patients was 66 years (IQR: 57–75). A total of 72 (29.4%) patients died during admission. From multivariate logistic regression, prognostic factors for in-hospital death included: Palliative Performance Scale (PPS) ≤ 30 (OR: 8.47, 95% CI: 3.47–20.66), Palliative Performance Scale 40–50% (OR: 2.79, 95% CI: 1.34–5.81), percentage of lymphocytes ≤ 8.0% (OR: 2.10, 95% CI: 1.08–4.08), and pulse oximetry ≤ 90% (OR: 2.01, 95% CI: 1.04–3.87). Conclusion The in-hospital death rate of cancer patients admitted with pneumonia was approximately 30%. The PPS of 10–30%, PPS of 40–50%, percentage of lymphocytes ≤ 8%, and oxygen saturation < 90% could serve as prognostic factors for in-hospital death. Further prospective studies are needed to investigate the usefulness of these factors. |
| first_indexed | 2024-04-11T00:20:13Z |
| format | Article |
| id | doaj.art-e161fc4ba8e748a59a75903ec10035cb |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-04-11T00:20:13Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-e161fc4ba8e748a59a75903ec10035cb2023-01-08T12:23:28ZengBMCBMC Palliative Care1472-684X2023-01-012211810.1186/s12904-023-01127-2Is aggressive care appropriate for patients with cancer complicated by pneumonia? A retrospective chart review in a tertiary hospitalChanchanok Aramrat0Thawalrat Ratanasiri1Patama Gomutbutra2Department of Family Medicine, Faculty of Medicine, Chiang Mai UniversityKarunruk Palliative Care Center, Faculty of Medicine, Srinagarind Hospital, Khon Kaen UniversityDepartment of Family Medicine, Faculty of Medicine, Chiang Mai UniversityAbstract Background Pneumonia in cancer patients is often problematic in order to decide whether to admit and administer antibiotics or pursue a comfort care pathway that may avoid in-hospital death. We aimed to identify factors which are easily assessed at admission in Thailand’s healthcare context that could serve as prognostic factors for in-hospital death. Methods Regression analysis was utilized to identify the prognostic factors from clinical factors collected at admission. The primary outcome was in-hospital death. Data was collected from the electronic medical records of Chiang Mai University Hospital, Thailand, from 2016 to 2017. Data on adult cancer patients admitted due to pneumonia were reviewed. Results In total, 245 patients were included, and 146 (59.6%) were male. The median age of the patients was 66 years (IQR: 57–75). A total of 72 (29.4%) patients died during admission. From multivariate logistic regression, prognostic factors for in-hospital death included: Palliative Performance Scale (PPS) ≤ 30 (OR: 8.47, 95% CI: 3.47–20.66), Palliative Performance Scale 40–50% (OR: 2.79, 95% CI: 1.34–5.81), percentage of lymphocytes ≤ 8.0% (OR: 2.10, 95% CI: 1.08–4.08), and pulse oximetry ≤ 90% (OR: 2.01, 95% CI: 1.04–3.87). Conclusion The in-hospital death rate of cancer patients admitted with pneumonia was approximately 30%. The PPS of 10–30%, PPS of 40–50%, percentage of lymphocytes ≤ 8%, and oxygen saturation < 90% could serve as prognostic factors for in-hospital death. Further prospective studies are needed to investigate the usefulness of these factors.https://doi.org/10.1186/s12904-023-01127-2CancerPneumoniaIn-hospital mortality ratePrognosisLymphocyteOxygen pulse |
| spellingShingle | Chanchanok Aramrat Thawalrat Ratanasiri Patama Gomutbutra Is aggressive care appropriate for patients with cancer complicated by pneumonia? A retrospective chart review in a tertiary hospital BMC Palliative Care Cancer Pneumonia In-hospital mortality rate Prognosis Lymphocyte Oxygen pulse |
| title | Is aggressive care appropriate for patients with cancer complicated by pneumonia? A retrospective chart review in a tertiary hospital |
| title_full | Is aggressive care appropriate for patients with cancer complicated by pneumonia? A retrospective chart review in a tertiary hospital |
| title_fullStr | Is aggressive care appropriate for patients with cancer complicated by pneumonia? A retrospective chart review in a tertiary hospital |
| title_full_unstemmed | Is aggressive care appropriate for patients with cancer complicated by pneumonia? A retrospective chart review in a tertiary hospital |
| title_short | Is aggressive care appropriate for patients with cancer complicated by pneumonia? A retrospective chart review in a tertiary hospital |
| title_sort | is aggressive care appropriate for patients with cancer complicated by pneumonia a retrospective chart review in a tertiary hospital |
| topic | Cancer Pneumonia In-hospital mortality rate Prognosis Lymphocyte Oxygen pulse |
| url | https://doi.org/10.1186/s12904-023-01127-2 |
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