被考虑入住重症监护室的实体恶性瘤患者的结果:单中心前性队列研究
Soraya Benguerfi1,2,3, Baptiste Hirsinger4, Judith Raimbourg5
1Service de Médecine Intensive Réanimation, CHU de Nantes, Nantes Université, France. soraya.benguerfi@gmail.com.
患有固体恶性瘤的患者,尽管生存率很好,但经常被拒绝接受ICU治疗. 糟糕的表现状况预测了拒绝和更高的死亡率,但像NEWS和qSOFA这样的得分对于预测结果并不有用.
科学领域:
- 在瘤学瘤学.
- 临界护理医学 临界护理医学
- 医疗 triage 医学分类
背景情况:
- 固体恶性瘤 (SM) 代表了需要重症监护评估的大量患者群体.
- 对于MS患者的ICU选决策涉及影响资源分配的复杂因素.
- 预测ICU中MS患者的结果对于明智的决策至关重要.
研究的目的:
- 在患有固体恶性瘤的患者中确定ICU分拣决策的预测因素.
- 确定与SM患者的ICU入院和拒绝相关的结果.
- 评估国家早期预警分数 (NEWS) 和快速序列器官衰竭评估 (qSOFA) 在SM的ICU分拣中的实用性.
主要方法:
- 针对ICU入院申请的MS患者进行前性队列研究.
- 纳入标准:SM患者,ICU请求,法国大学医院,2019年7月至2021年12月.
- 收集的数据:人口统计,癌症特征,表现状况,分拣分数,ICU入院和死亡率.
主要成果:
- 在410名MS患者中,42.9%被接收到ICU,而80.1%的患者在住院后幸存下来.
- 与ICU入院相关的因素包括乳腺癌,血和肺胸.
- 年龄较大,表现不佳,转移性疾病和夜间请求与ICU拒绝有关;NEWS和qSOFA显示死亡率的预测值较差.
结论:
- 尽管在医院生存率有利,但MS患者经常被拒绝进入ICU.
- 低绩效状态是ICU拒绝和6个月死亡率增加的关键预测因素.
- 标准的生理评分系统 (NEWS,qSOFA) 在预测ICU分拣中MS患者的结果方面具有有限的实用性.
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