Assessment of mortality and performance status in critically ill cancer patients: A retrospective cohort study
Given clinicians' frequent concerns about unfavourable outcomes, Intensive Care Unit (ICU) triage decisions in acutely ill cancer patients can be difficult, as clinicians may have doubts about the appropriateness of an ICU admission. To aid to this decision making, we studied the survival and p...
Gespeichert in:
| Veröffentlicht in: | PloS one 2021-06, Vol.16 (6), p.e0252771-e0252771 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e0252771 |
|---|---|
| container_issue | 6 |
| container_start_page | e0252771 |
| container_title | PloS one |
| container_volume | 16 |
| creator | van der Zee, Esther N Noordhuis, Lianne M Epker, Jelle L van Leeuwen, Nikki Wijnhoven, Bas P. L Benoit, Dominique D Bakker, Jan Kompanje, Erwin J. O |
| description | Given clinicians' frequent concerns about unfavourable outcomes, Intensive Care Unit (ICU) triage decisions in acutely ill cancer patients can be difficult, as clinicians may have doubts about the appropriateness of an ICU admission. To aid to this decision making, we studied the survival and performance status of cancer patients 2 years following an unplanned ICU admission. This was a retrospective cohort study in a large tertiary referral university hospital in the Netherlands. We categorized all adult patients with an unplanned ICU admission in 2017 into two groups: patients with or without an active malignancy. Descriptive statistics, Pearson's Chi-square tests and the Mann-Whitney U tests were used to evaluate the primary objective 2-year mortality and performance status. A good performance status was defined as ECOG performance status 0 (fully active) or 1 (restricted in physically strenuous activity but ambulatory and able to carry out light work). A multivariable binary logistic regression analysis was used to identify factors associated with 2-year mortality within cancer patients. Of the 1046 unplanned ICU admissions, 125 (12%) patients had cancer. The 2-year mortality in patients with cancer was significantly higher than in patients without cancer (72% and 42.5%, P |
| doi_str_mv | 10.1371/journal.pone.0252771 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_2540099822</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A664891013</galeid><doaj_id>oai_doaj_org_article_43f59fd92f354f328529d856331a7c99</doaj_id><sourcerecordid>A664891013</sourcerecordid><originalsourceid>FETCH-LOGICAL-c669t-6a1e5f5f8ecdbe0801eb6fb8006f9a0cf94e85a7b992f809b8708cfe500139b63</originalsourceid><addsrcrecordid>eNqNk12L1DAUhoso7rr6DwQDgujFjPlo0sQLYVj8GFhY8Os2pGkykyFtZpN0cf69GafKVvZCetGSPHlOz0tOVT1HcIlIg97uwhgH5Zf7MJglxBQ3DXpQnSNB8IJhSB7e-T6rnqS0g5ASztjj6ozUCNHCn1fDKiWTUm-GDIIFfYhZeZcPQA0d2JtoQ-zVoA1IWeUxATcAHV12Wnl_AM57oI_bEexVdkWS3oEViCbHkPZGZ3drgA7bYi2CsTs8rR5Z5ZN5Nr0vqu8fP3y7_Ly4uv60vlxdLTRjIi-YQoZaarnRXWsgh8i0zLYcQmaFgtqK2nCqmlYIbDkULW8g19ZQCBERLSMX1YuTd-9DklNUSWJaQygEx7gQ6xPRBbWT--h6FQ8yKCd_L4S4kSqWPr2RNbFU2K6UIrS2BHOKRccpIwSpRgtRXO-namPbm06XHKLyM-l8Z3BbuQm3kiNBiSBF8HoSxHAzmpRl75I23qvBhPH03xQjhpuCvvwHvb-7idqo0oAbbCh19VEqV4zVXKASVKGW91Dl6UzvdLlX1pX12YE3swOFyeZn3qgxJbn--uX_2esfc_bVHXZrlM_bFPyYXRjSHKxPoC4XLEVj_4aMoDyOxZ805HEs5DQW5BeFif74</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2540099822</pqid></control><display><type>article</type><title>Assessment of mortality and performance status in critically ill cancer patients: A retrospective cohort study</title><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Public Library of Science (PLoS)</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>van der Zee, Esther N ; Noordhuis, Lianne M ; Epker, Jelle L ; van Leeuwen, Nikki ; Wijnhoven, Bas P. L ; Benoit, Dominique D ; Bakker, Jan ; Kompanje, Erwin J. O</creator><contributor>Yunusa, Ismaeel</contributor><creatorcontrib>van der Zee, Esther N ; Noordhuis, Lianne M ; Epker, Jelle L ; van Leeuwen, Nikki ; Wijnhoven, Bas P. L ; Benoit, Dominique D ; Bakker, Jan ; Kompanje, Erwin J. O ; Yunusa, Ismaeel</creatorcontrib><description>Given clinicians' frequent concerns about unfavourable outcomes, Intensive Care Unit (ICU) triage decisions in acutely ill cancer patients can be difficult, as clinicians may have doubts about the appropriateness of an ICU admission. To aid to this decision making, we studied the survival and performance status of cancer patients 2 years following an unplanned ICU admission. This was a retrospective cohort study in a large tertiary referral university hospital in the Netherlands. We categorized all adult patients with an unplanned ICU admission in 2017 into two groups: patients with or without an active malignancy. Descriptive statistics, Pearson's Chi-square tests and the Mann-Whitney U tests were used to evaluate the primary objective 2-year mortality and performance status. A good performance status was defined as ECOG performance status 0 (fully active) or 1 (restricted in physically strenuous activity but ambulatory and able to carry out light work). A multivariable binary logistic regression analysis was used to identify factors associated with 2-year mortality within cancer patients. Of the 1046 unplanned ICU admissions, 125 (12%) patients had cancer. The 2-year mortality in patients with cancer was significantly higher than in patients without cancer (72% and 42.5%, P <0.001). The median performance status at 2 years in cancer patients was 1 (IQR 0-2). Only an ECOG performance status of 2 (OR 8.94; 95% CI 1.21-65.89) was independently associated with 2-year mortality. In our study, the majority of the survivors have a good performance status 2 years after ICU admission. However, at that point, three-quarter of these cancer patients had died, and mortality in cancer patients was significantly higher than in patients without cancer. ICU admission decisions in acutely ill cancer patients should be based on performance status, severity of illness and long-term prognosis, and this should be communicated in the shared decision making. An ICU admission decision should not solely be based on the presence of a malignancy.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0252771</identifier><identifier>PMID: 34115771</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Biology and Life Sciences ; Blood cancer ; Cancer ; Cancer patients ; Cancer therapies ; Cohort analysis ; Comorbidity ; Critical care ; Critically ill ; Decision making ; Editing ; Electronic health records ; Health care facilities ; Hematology ; Hospitals ; Intensive care ; Medical prognosis ; Medicine and Health Sciences ; Metastasis ; Methodology ; Morbidity ; Mortality ; Patient outcomes ; Patients ; Population ; Public health ; Pulmonology ; Remission ; Skin cancer ; Standard deviation ; Stem cells ; Surgery ; Transplants & implants</subject><ispartof>PloS one, 2021-06, Vol.16 (6), p.e0252771-e0252771</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 van der Zee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 van der Zee et al 2021 van der Zee et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c669t-6a1e5f5f8ecdbe0801eb6fb8006f9a0cf94e85a7b992f809b8708cfe500139b63</citedby><cites>FETCH-LOGICAL-c669t-6a1e5f5f8ecdbe0801eb6fb8006f9a0cf94e85a7b992f809b8708cfe500139b63</cites><orcidid>0000-0003-0431-4659</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195393/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195393/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,862,883,2098,2917,23853,27911,27912,53778,53780,79355,79356</link.rule.ids></links><search><contributor>Yunusa, Ismaeel</contributor><creatorcontrib>van der Zee, Esther N</creatorcontrib><creatorcontrib>Noordhuis, Lianne M</creatorcontrib><creatorcontrib>Epker, Jelle L</creatorcontrib><creatorcontrib>van Leeuwen, Nikki</creatorcontrib><creatorcontrib>Wijnhoven, Bas P. L</creatorcontrib><creatorcontrib>Benoit, Dominique D</creatorcontrib><creatorcontrib>Bakker, Jan</creatorcontrib><creatorcontrib>Kompanje, Erwin J. O</creatorcontrib><title>Assessment of mortality and performance status in critically ill cancer patients: A retrospective cohort study</title><title>PloS one</title><description>Given clinicians' frequent concerns about unfavourable outcomes, Intensive Care Unit (ICU) triage decisions in acutely ill cancer patients can be difficult, as clinicians may have doubts about the appropriateness of an ICU admission. To aid to this decision making, we studied the survival and performance status of cancer patients 2 years following an unplanned ICU admission. This was a retrospective cohort study in a large tertiary referral university hospital in the Netherlands. We categorized all adult patients with an unplanned ICU admission in 2017 into two groups: patients with or without an active malignancy. Descriptive statistics, Pearson's Chi-square tests and the Mann-Whitney U tests were used to evaluate the primary objective 2-year mortality and performance status. A good performance status was defined as ECOG performance status 0 (fully active) or 1 (restricted in physically strenuous activity but ambulatory and able to carry out light work). A multivariable binary logistic regression analysis was used to identify factors associated with 2-year mortality within cancer patients. Of the 1046 unplanned ICU admissions, 125 (12%) patients had cancer. The 2-year mortality in patients with cancer was significantly higher than in patients without cancer (72% and 42.5%, P <0.001). The median performance status at 2 years in cancer patients was 1 (IQR 0-2). Only an ECOG performance status of 2 (OR 8.94; 95% CI 1.21-65.89) was independently associated with 2-year mortality. In our study, the majority of the survivors have a good performance status 2 years after ICU admission. However, at that point, three-quarter of these cancer patients had died, and mortality in cancer patients was significantly higher than in patients without cancer. ICU admission decisions in acutely ill cancer patients should be based on performance status, severity of illness and long-term prognosis, and this should be communicated in the shared decision making. An ICU admission decision should not solely be based on the presence of a malignancy.</description><subject>Biology and Life Sciences</subject><subject>Blood cancer</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Cancer therapies</subject><subject>Cohort analysis</subject><subject>Comorbidity</subject><subject>Critical care</subject><subject>Critically ill</subject><subject>Decision making</subject><subject>Editing</subject><subject>Electronic health records</subject><subject>Health care facilities</subject><subject>Hematology</subject><subject>Hospitals</subject><subject>Intensive care</subject><subject>Medical prognosis</subject><subject>Medicine and Health Sciences</subject><subject>Metastasis</subject><subject>Methodology</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Population</subject><subject>Public health</subject><subject>Pulmonology</subject><subject>Remission</subject><subject>Skin cancer</subject><subject>Standard deviation</subject><subject>Stem cells</subject><subject>Surgery</subject><subject>Transplants & implants</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk12L1DAUhoso7rr6DwQDgujFjPlo0sQLYVj8GFhY8Os2pGkykyFtZpN0cf69GafKVvZCetGSPHlOz0tOVT1HcIlIg97uwhgH5Zf7MJglxBQ3DXpQnSNB8IJhSB7e-T6rnqS0g5ASztjj6ozUCNHCn1fDKiWTUm-GDIIFfYhZeZcPQA0d2JtoQ-zVoA1IWeUxATcAHV12Wnl_AM57oI_bEexVdkWS3oEViCbHkPZGZ3drgA7bYi2CsTs8rR5Z5ZN5Nr0vqu8fP3y7_Ly4uv60vlxdLTRjIi-YQoZaarnRXWsgh8i0zLYcQmaFgtqK2nCqmlYIbDkULW8g19ZQCBERLSMX1YuTd-9DklNUSWJaQygEx7gQ6xPRBbWT--h6FQ8yKCd_L4S4kSqWPr2RNbFU2K6UIrS2BHOKRccpIwSpRgtRXO-namPbm06XHKLyM-l8Z3BbuQm3kiNBiSBF8HoSxHAzmpRl75I23qvBhPH03xQjhpuCvvwHvb-7idqo0oAbbCh19VEqV4zVXKASVKGW91Dl6UzvdLlX1pX12YE3swOFyeZn3qgxJbn--uX_2esfc_bVHXZrlM_bFPyYXRjSHKxPoC4XLEVj_4aMoDyOxZ805HEs5DQW5BeFif74</recordid><startdate>20210611</startdate><enddate>20210611</enddate><creator>van der Zee, Esther N</creator><creator>Noordhuis, Lianne M</creator><creator>Epker, Jelle L</creator><creator>van Leeuwen, Nikki</creator><creator>Wijnhoven, Bas P. L</creator><creator>Benoit, Dominique D</creator><creator>Bakker, Jan</creator><creator>Kompanje, Erwin J. O</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-0431-4659</orcidid></search><sort><creationdate>20210611</creationdate><title>Assessment of mortality and performance status in critically ill cancer patients: A retrospective cohort study</title><author>van der Zee, Esther N ; Noordhuis, Lianne M ; Epker, Jelle L ; van Leeuwen, Nikki ; Wijnhoven, Bas P. L ; Benoit, Dominique D ; Bakker, Jan ; Kompanje, Erwin J. O</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c669t-6a1e5f5f8ecdbe0801eb6fb8006f9a0cf94e85a7b992f809b8708cfe500139b63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Biology and Life Sciences</topic><topic>Blood cancer</topic><topic>Cancer</topic><topic>Cancer patients</topic><topic>Cancer therapies</topic><topic>Cohort analysis</topic><topic>Comorbidity</topic><topic>Critical care</topic><topic>Critically ill</topic><topic>Decision making</topic><topic>Editing</topic><topic>Electronic health records</topic><topic>Health care facilities</topic><topic>Hematology</topic><topic>Hospitals</topic><topic>Intensive care</topic><topic>Medical prognosis</topic><topic>Medicine and Health Sciences</topic><topic>Metastasis</topic><topic>Methodology</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Population</topic><topic>Public health</topic><topic>Pulmonology</topic><topic>Remission</topic><topic>Skin cancer</topic><topic>Standard deviation</topic><topic>Stem cells</topic><topic>Surgery</topic><topic>Transplants & implants</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van der Zee, Esther N</creatorcontrib><creatorcontrib>Noordhuis, Lianne M</creatorcontrib><creatorcontrib>Epker, Jelle L</creatorcontrib><creatorcontrib>van Leeuwen, Nikki</creatorcontrib><creatorcontrib>Wijnhoven, Bas P. L</creatorcontrib><creatorcontrib>Benoit, Dominique D</creatorcontrib><creatorcontrib>Bakker, Jan</creatorcontrib><creatorcontrib>Kompanje, Erwin J. O</creatorcontrib><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van der Zee, Esther N</au><au>Noordhuis, Lianne M</au><au>Epker, Jelle L</au><au>van Leeuwen, Nikki</au><au>Wijnhoven, Bas P. L</au><au>Benoit, Dominique D</au><au>Bakker, Jan</au><au>Kompanje, Erwin J. O</au><au>Yunusa, Ismaeel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of mortality and performance status in critically ill cancer patients: A retrospective cohort study</atitle><jtitle>PloS one</jtitle><date>2021-06-11</date><risdate>2021</risdate><volume>16</volume><issue>6</issue><spage>e0252771</spage><epage>e0252771</epage><pages>e0252771-e0252771</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Given clinicians' frequent concerns about unfavourable outcomes, Intensive Care Unit (ICU) triage decisions in acutely ill cancer patients can be difficult, as clinicians may have doubts about the appropriateness of an ICU admission. To aid to this decision making, we studied the survival and performance status of cancer patients 2 years following an unplanned ICU admission. This was a retrospective cohort study in a large tertiary referral university hospital in the Netherlands. We categorized all adult patients with an unplanned ICU admission in 2017 into two groups: patients with or without an active malignancy. Descriptive statistics, Pearson's Chi-square tests and the Mann-Whitney U tests were used to evaluate the primary objective 2-year mortality and performance status. A good performance status was defined as ECOG performance status 0 (fully active) or 1 (restricted in physically strenuous activity but ambulatory and able to carry out light work). A multivariable binary logistic regression analysis was used to identify factors associated with 2-year mortality within cancer patients. Of the 1046 unplanned ICU admissions, 125 (12%) patients had cancer. The 2-year mortality in patients with cancer was significantly higher than in patients without cancer (72% and 42.5%, P <0.001). The median performance status at 2 years in cancer patients was 1 (IQR 0-2). Only an ECOG performance status of 2 (OR 8.94; 95% CI 1.21-65.89) was independently associated with 2-year mortality. In our study, the majority of the survivors have a good performance status 2 years after ICU admission. However, at that point, three-quarter of these cancer patients had died, and mortality in cancer patients was significantly higher than in patients without cancer. ICU admission decisions in acutely ill cancer patients should be based on performance status, severity of illness and long-term prognosis, and this should be communicated in the shared decision making. An ICU admission decision should not solely be based on the presence of a malignancy.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>34115771</pmid><doi>10.1371/journal.pone.0252771</doi><tpages>e0252771</tpages><orcidid>https://orcid.org/0000-0003-0431-4659</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-06, Vol.16 (6), p.e0252771-e0252771 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2540099822 |
| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Biology and Life Sciences Blood cancer Cancer Cancer patients Cancer therapies Cohort analysis Comorbidity Critical care Critically ill Decision making Editing Electronic health records Health care facilities Hematology Hospitals Intensive care Medical prognosis Medicine and Health Sciences Metastasis Methodology Morbidity Mortality Patient outcomes Patients Population Public health Pulmonology Remission Skin cancer Standard deviation Stem cells Surgery Transplants & implants |
| title | Assessment of mortality and performance status in critically ill cancer patients: A retrospective cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-15T20%3A23%3A53IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Assessment%20of%20mortality%20and%20performance%20status%20in%20critically%20ill%20cancer%20patients:%20A%20retrospective%20cohort%20study&rft.jtitle=PloS%20one&rft.au=van%20der%20Zee,%20Esther%20N&rft.date=2021-06-11&rft.volume=16&rft.issue=6&rft.spage=e0252771&rft.epage=e0252771&rft.pages=e0252771-e0252771&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0252771&rft_dat=%3Cgale_plos_%3EA664891013%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2540099822&rft_id=info:pmid/34115771&rft_galeid=A664891013&rft_doaj_id=oai_doaj_org_article_43f59fd92f354f328529d856331a7c99&rfr_iscdi=true |