Artikel ; Online: Elderly patients with cancer admitted to intensive care unit: A multicenter study in a middle-income country.
PloS one
2020 Band 15, Heft 8, Seite(n) e0238124
Abstract: Background: Very elderly critically ill patients (ie, those older than 75 or 80 years) are an increasing population in intensive care units. However, patients with cancer have encompassed only a minority in epidemiological studies of very old critically- ...
| Abstract | Background: Very elderly critically ill patients (ie, those older than 75 or 80 years) are an increasing population in intensive care units. However, patients with cancer have encompassed only a minority in epidemiological studies of very old critically-ill patients. We aimed to describe clinical characteristics and identify factors associated with hospital mortality in a cohort of patients aged 80 or older with cancer admitted to intensive care units (ICUs). Methods: This was a retrospective cohort study in 94 ICUs in Brazil. We included patients aged 80 years or older with active cancer who had an unplanned admission. We performed a mixed effect logistic regression model to identify variables independently associated with hospital mortality. Results: Of 4604 included patients, 1807 (39.2%) died in hospital. Solid metastatic (OR = 2.46; CI 95%, 2.01-3.00), hematological cancer (OR = 2.32; CI 95%, 1.75-3.09), moderate/severe performance status impairment (OR = 1.59; CI 95%, 1.33-1.90) and use of vasopressors (OR = 4.74; CI 95%, 3.88-5.79), mechanical ventilation (OR = 1.54; CI 95%, 1.25-1.89) and renal replacement (OR = 1.81; CI 95%, 1.29-2.55) therapy were independently associated with increased hospital mortality. Emergency surgical admissions were associated with lower mortality compared to medical admissions (OR = 0.71; CI 95%, 0.52-0.96). Conclusions: Hospital mortality rate in very elderly critically ill patients with cancer with unplanned ICU admissions are lower than expected a priori. Cancer characteristics, performance status impairment and acute organ dysfunctions are associated with increased mortality. |
|---|---|
| Mesh-Begriff(e) | APACHE ; Aged, 80 and over ; Brazil ; Cohort Studies ; Critical Illness/mortality ; Female ; Hematologic Neoplasms/mortality ; Hematologic Neoplasms/pathology ; Hospital Mortality/trends ; Hospitalization ; Humans ; Intensive Care Units ; Logistic Models ; Male ; Neoplasms/mortality ; Neoplasms/pathology ; Retrospective Studies ; Risk Factors |
| Sprache | Englisch |
| Erscheinungsdatum | 2020-08-21 |
| Erscheinungsland | United States |
| Dokumenttyp | Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't |
| ISSN | 1932-6203 |
| ISSN (online) | 1932-6203 |
| DOI | 10.1371/journal.pone.0238124 |
| Datenquelle | MEDical Literature Analysis and Retrieval System OnLINE |
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