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Pacientes oncológicos ingresados en Unidad de Cuidados Intensivos. Análisis de factores predictivos de mortalidad / Oncological patients admitted to an intensive care unit. Analysis of predictors of in-hospital mortality
Díaz-Díaz, D; Villanova Martínez, M; Palencia Herrejón, E.
Afiliação
  • Díaz-Díaz, D; Hospital Universitario Infanta Leonor. Servicio de Medicina Intensiva. Madrid. España
  • Villanova Martínez, M; Hospital Universitario Infanta Leonor. Servicio de Medicina Intensiva. Madrid. España
  • Palencia Herrejón, E; Hospital Universitario Infanta Leonor. Servicio de Medicina Intensiva. Madrid. España
Med. intensiva (Madr., Ed. impr.) ; 42(6): 346-353, ago.-sept. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-178646
Biblioteca responsável: ES1.1
Localização: BNCS
RESUMEN

OBJETIVO:

Analizar qué factores clínicos influyen en la mortalidad de pacientes con cáncer que ingresan en UCI.

DISEÑO:

Estudio observacional retrospectivo. Ámbito UCI de un hospital secundario. PACIENTES Adultos ingresados en UCI con diagnóstico de cáncer (sólido o hematológico), excluyendo a aquellos ingresados en el postoperatorio de resección programada del tumor o con estancia inferior a 24 h en UCI. INTERVENCIONES Revisión de datos clínicos. Variables de interés Tipo de tumor, extensión, escala oncológica funcional Eastern Cooperative Oncology Group (ECOG), motivo de ingreso en UCI, gravedad (SOFA, APACHE-II, SAPS-II), terapia recibida y mortalidad hospitalaria.

RESULTADOS:

Se incluyó a 167 pacientes (edad media 71,1 años; 62,9% varones; el 79% con tumor sólido), de los cuales fallecieron 61 (36%) durante su estancia hospitalaria (35 en UCI). Los factores clínicos asociados a mayor riesgo de muerte hospitalaria fueron la puntuación 3-4 en la escala ECOG (OR 7,23; IC 95% 1,95-26,87), extensión metastásica del tumor (OR 3,77; IC 95% 1,70-8,36), insuficiencia renal (OR 3,66; IC 95% 1,49-8,95) y puntuación SOFA al ingreso (OR 1,26; IC 95% 1,10-1,43). El 60,3% de los supervivientes eran independientes al alta hospitalaria.

CONCLUSIONES:

En nuestra serie, solo un tercio de los pacientes con enfermedad oncológica grave que requieren ingreso en UCI fallecen durante el ingreso hospitalario y más de la mitad de los supervivientes presentan una situación de independencia al alta hospitalaria. Los factores clínicos asociados a la mortalidad hospitalaria fueron la mala situación funcional previa, el antecedente de tumor metastásico, la puntuación SOFA al ingreso en UCI y la presencia de insuficiencia renal aguda
ABSTRACT

OBJECTIVE:

To analyze the factors influencing in-hospital mortality among cancer patients admitted to an Intensive Care Unit (ICU).

DESIGN:

A retrospective observational study was carried out.

SETTING:

The ICU of a community hospital. PATIENTS Adults diagnosed with solid or hematological malignancies admitted to the ICU, excluding those admitted after scheduled surgery and those with an ICU stay of under 24h.

INTERVENTIONS:

Review of clinical data. Variables of interest Referring ward and length of stay prior to admission to the ICU, type of tumor, extent, Eastern Cooperative Oncology Group (ECOG) score, reason for ICU admission, severity (SOFA, APACHE-II, SAPS-II), type of therapy received in the ICU, and in-hospital mortality.

RESULTS:

A total of 167 patients (mean age 71.1 years, 62.9% males; 79% solid tumors) were included, of which 61 (36%) died during their hospital stay (35 in the ICU). The factors associated to increased in-hospital mortality were ECOG scores 3-4 (OR 7.23, 95%CI 1.95-26.87), metastatic disease (OR 3.77, 95%CI 1.70-8.36), acute kidney injury (OR 3.66, 95%CI 1.49-8.95) and SOFA score at ICU admission (OR 1.26, 95%CI 1.10-1.43). A total of 60.3% of the survivors were independent at hospital discharge.

CONCLUSIONS:

In our series, only one-third of the critically ill cancer patients admitted to the ICU died during hospital admission, and more than 50% showed good performance status at hospital discharge. The clinical prognostic factors associated to in-hospital mortality were poor performance status, metastatic disease, SOFA score at ICU admission and acute kidney injury
Assuntos

Texto completo: Disponível Coleções: Bases de dados nacionais / Espanha Base de dados: IBECS Assunto principal: Mortalidade Hospitalar / Neoplasias Limite: Idoso / Feminino / Humanos / Masculino Idioma: Espanhol Revista: Med. intensiva (Madr., Ed. impr.) Ano de publicação: 2018 Tipo de documento: Artigo Instituição/País de afiliação: Hospital Universitario Infanta Leonor/España

Texto completo: Disponível Coleções: Bases de dados nacionais / Espanha Base de dados: IBECS Assunto principal: Mortalidade Hospitalar / Neoplasias Limite: Idoso / Feminino / Humanos / Masculino Idioma: Espanhol Revista: Med. intensiva (Madr., Ed. impr.) Ano de publicação: 2018 Tipo de documento: Artigo Instituição/País de afiliação: Hospital Universitario Infanta Leonor/España
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