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KMID : 1144420180330030121
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Acute and Critical Care
2018 Volume.33 No. 3 p.121 ~ p.129
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Characteristics and Clinical Outcomes of Critically Ill Cancer Patients Admitted to Korean Intensive Care Units
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Na Soo-Jin
Ha Tae-Sun
Koh Youn-Suck
Suh Gee-Young
Koh Shin-Ok
Lim Chae-Man
Choi Won-Il
Lee Young-Joo
Kim Seok-Chan
Chon Gyu-Rak
Kim Je-Hyeong
Kim Jae-Yeol
Lim Jae-Min
Park Sung-Hoon
Kim Ho-Cheol
Lee Jin-Hwa
Lee Ji-Hyun
Park Ji-Sook
Cho Ju-Hee
Jeon Kyeong-Man
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Abstract
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Background: The objective of this study was to investigate the characteristics and clinical outcomes of critically ill cancer patients admitted to intensive care units (ICUs) in Korea.
Methods: This was a retrospective cohort study that analyzed prospective collected data from the Validation of Simplified Acute Physiology Score 3 (SAPS3) in Korean ICU (VSKI) study, which is a nationwide, multicenter, and prospective study that considered 5,063 patients from 22 ICUs in Korea over a period of 7 months. Among them, patients older than 18 years of age who were diagnosed with solid or hematologic malignancies prior to admission to the ICU were included in the present study.
Results: During the study period, a total of 1,762 cancer patients were admitted to the ICUs and 833 of them were deemed eligible for analysis. Six hundred fifty-eight (79%) had solid tumors and 175 (21%) had hematologic malignancies, respectively. Respiratory problems (30.1%) was the most common reason leading to ICU admission. Patients with hematologic malignancies had higher Sequential Organ Failure Assessment (12 vs. 8, P<0.001) and SAPS3 (71 vs. 69, P<0.001) values and were more likely to be associated with chemotherapy, steroid therapy, and immunocompromised status versus patients with solid tumors. The use of inotropes/ vasopressors, mechanical ventilation, and/or continuous renal replacement therapy was more frequently required in hematologic malignancy patients. Mortality rates in the ICU (41.7% vs. 24.6%, P<0.001) and hospital (53.1% vs. 38.6%, P=0.002) were higher in hematologic malignancy patients than in solid tumor patients.
Conclusions: Cancer patients accounted for one-third of all patients admitted to the studied ICUs in Korea. Clinical characteristics were different according to the type of malignancy. Patients with hematologic malignancies had a worse prognosis than did patients with solid tumor.
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KEYWORD
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cancer, critical care, epidemiology, hematologic neoplasm, mortality
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