학술논문
Characteristics and short-term outcomes of patients with esophageal cancer with unplanned intensive care unit admissions: a retrospective cohort study.
Document Type
Academic Journal
Author
Freitas ICL; A. C. Camargo Cancer Center, São Paulo, SP, Brasil.; Assis DM; Hospital de Câncer de Barretos, Barretos, SP, Brasil.; Amendola CP; Hospital de Câncer de Barretos, Barretos, SP, Brasil.; Russo DDS; Hospital Moinhos de Vento, Porto Alegre, RS, Brasil.; Moraes APP; Hospital de Câncer do Maranhão 'Tarquínio Lopes Filho', São Luís, MA, Brasil.; Caruso P; A. C. Camargo Cancer Center, São Paulo, SP, Brasil.; Nassar Júnior AP; A. C. Camargo Cancer Center, São Paulo, SP, Brasil.
Source
Publisher: Associação de Medicina Intensiva Brasileira Country of Publication: Brazil NLM ID: 9506692 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1982-4335 (Electronic) Linking ISSN: 0103507X NLM ISO Abbreviation: Rev Bras Ter Intensiva Subsets: MEDLINE
Subject
Language
English; Portuguese
Abstract
Objective: To depict the clinical presentation and outcomes of a cohort of critically ill patients with esophageal cancer.
Methods: We carried out a multicenter retrospective study that included patients with esophageal cancer admitted to intensive care units with acute illness between September 2009 and December 2017. We collected the demographic and clinical characteristics of all included patients, as well as organ-support measures and hospital outcomes. We performed logistic regression analysis to identify independent factors associated with in-hospital mortality.
Results: Of 226 patients included in the study, 131 (58.0%) patients died before hospital discharge. Squamous cell carcinoma was more frequent than adenocarcinoma, and 124 (54.9%) patients had metastatic cancer. The main reasons for admission were sepsis/septic shock and acute respiratory failure. Mechanical ventilation (OR = 6.18; 95%CI 2.86 - 13.35) and metastatic disease (OR = 7.10; 95%CI 3.35 - 15.05) were independently associated with in-hospital mortality.
Conclusion: In this cohort of patients with esophageal cancer admitted to intensive care units with acute illness, the in-hospital mortality rate was very high. The requirement for invasive mechanical ventilation and metastatic disease were independent prognostic factors and should be considered in discussions about the short-term outcomes of these patients.
Methods: We carried out a multicenter retrospective study that included patients with esophageal cancer admitted to intensive care units with acute illness between September 2009 and December 2017. We collected the demographic and clinical characteristics of all included patients, as well as organ-support measures and hospital outcomes. We performed logistic regression analysis to identify independent factors associated with in-hospital mortality.
Results: Of 226 patients included in the study, 131 (58.0%) patients died before hospital discharge. Squamous cell carcinoma was more frequent than adenocarcinoma, and 124 (54.9%) patients had metastatic cancer. The main reasons for admission were sepsis/septic shock and acute respiratory failure. Mechanical ventilation (OR = 6.18; 95%CI 2.86 - 13.35) and metastatic disease (OR = 7.10; 95%CI 3.35 - 15.05) were independently associated with in-hospital mortality.
Conclusion: In this cohort of patients with esophageal cancer admitted to intensive care units with acute illness, the in-hospital mortality rate was very high. The requirement for invasive mechanical ventilation and metastatic disease were independent prognostic factors and should be considered in discussions about the short-term outcomes of these patients.