Oncologists' and Intensivists' Attitudes Toward the Care of Critically Ill Patients with Cancer

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Arquivos
art_NASSAR JR._Oncologists_and_Intensivists_Attitudes_Toward_the_Care_of_2019.PDF (235.56 KB)
Citações na Scopus
17
Tipo de produção
article
Data de publicação
2019
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
SAGE PUBLICATIONS INC
Autores
DETTINO, Aldo Lourenco Abadde
AMENDOLA, Cristina Prata
SANTOS, Rodrigo Alves dos
Citação
JOURNAL OF INTENSIVE CARE MEDICINE, v.34, n.10, p.811-817, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: Patients with cancer represent an important proportion of intensive care unit (ICU) admissions. Oncologists and intensivists have distinct knowledge backgrounds, and conflicts about the appropriate management of these patients may emerge. Methods: We surveyed oncologists and intensivists at 2 academic cancer centers regarding their management of 2 hypothetical patients with different cancer types (metastatic pancreatic cancer and metastatic breast cancer with positive receptors for estrogen, progesterone, and HER-2) who develop septic shock and multiple organ failure. Results: Sixty intensivists and 46 oncologists responded to the survey. Oncologists and intensivists similarly favored withdrawal of life support measures for the patient with pancreatic cancer (33/46 [72%] vs 48/60 [80%], P = .45). On the other hand, intensivists favored more withdrawal of life support measures for the patient with breast cancer compared to oncologists (32/59 [54%] vs 9/44 [21%], P < .001). In the multinomial logistic regression, the oncology specialists were more likely to advocate for a full-code status for the patient with breast cancer (OR = 5.931; CI 95%, 1.762-19.956; P = .004). Conclusions: Oncologists and intensivists share different views regarding life support measures in critically ill patients with cancer. Oncologists tend to focus on the cancer characteristics, whereas intensivists focus on multiple organ failure when weighing in on the same decisions. Regular meetings between oncologists and intensivists may reduce possible conflicts regarding the critical care of patients with cancer.
Palavras-chave
cancer, critical care, decision-making, mechanical ventilation, mortality
URI
https://observatorio.fm.usp.br/handle/OPI/33586
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Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/09
Artigos e Materiais de Revistas Científicas - LIM/51
Artigos e Materiais de Revistas Científicas - ODS/03