接受重症监护的瘤患者的死亡率真的更高吗? 一个匹配的队列观察性研究
Marta Zafra Poves1,2,3, Maria Angeles Vicente Conesa1,2,3, Maria Esperanza Guirao García1,2,3
1Department of Medical Oncology, Hospital General Universitario Morales Meseguer, Av. Marqués de los Vélez, s/n. 30008, Murcia, Spain.
概括
进入重症监护室 (ICU) 的癌症患者的粗死亡率更高. 然而,当疾病严重程度和并发症相匹配时,结果与非癌症患者相似,这表明ICU护理适用于选择的癌症患者.
科学领域:
- 关键护理医学 关键护理医学
- 在瘤学瘤学.
- 医学统计 医学统计
背景情况:
- 癌症患者经常经历关键事件,需要进入重症监护室 (ICU).
- 预后不确定性可能会推迟癌症患者的重症监护转诊.
- 这项研究比较了成年固体瘤患者和非癌症对照患者之间的ICU生存率.
研究的目的:
- 为了比较成年人的重症监护病房 (ICU) 存活率,固体瘤应急入院与非癌症对照.
- 评估疾病严重程度和并发症对ICU癌症患者的治疗结果的影响.
主要方法:
- 对167名成人固体瘤患者的回顾性分析,这些患者被录入混合ICU (2010-2016).
- 基于人口统计,功能状态,入院诊断和严重程度得分 (SOFA,SAPS II,查尔森并发症指数) 的两个非癌症队伍的倾向匹配比较.
- 主要结局:ICU死亡率. 二次结局:医院死亡率和90天生存率.
主要成果:
- 癌症患者占ICU入院的4.8%,常见原因包括转移性疾病,急性呼吸衰竭和败血症/休克.
- 最初,癌症患者的ICU和医院死亡率高于对照组 (分别为27.5%与10.8%和35.3%与16.2%).
- 在对严重程度和并发症进行匹配后,ICU和医院死亡率的差异是无意义的 (27.5%对19.8%和35.3%对28.7%). 当严重程度和并发症相匹配时,90天的生存率相似 (64.7%vs71.3%).
结论:
- 进入ICU的固体瘤患者往往病情更严重,导致较高的粗死亡率.
- 当疾病严重程度和并发症相似时,癌症患者的结果与非癌症患者的结果相似.
- 对于具有可逆性严重疾病和可接受的基线状态的癌症患者,应考虑重症监护,因为仅仅癌症诊断并不是ICU入院的禁忌.
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