Characteristics of critically ill patients with cancer associated with intensivist's perception of inappropriateness of ICU admission: A retrospective cohort study

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art_SILVA_Characteristics_of_critically_ill_patients_with_cancer_associated_2024.PDF (1.52 MB)
Citações na Scopus
0
Tipo de produção
article
Data de publicação
2024
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
W B SAUNDERS CO-ELSEVIER INC
Autores
SILVA, Carla Marchini Dias da
JR, Antonio Paulo Nassar
Citação
JOURNAL OF CRITICAL CARE, v.79, article ID 154468, 7p, 2024
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Purpose: Although admitting cancer patients to the ICU is no longer an issue, it may be valuable to identify patients perceived least likely to benefit from admission. Our objective was to investigate factors associated with potentially inappropriate ICU admission. Methods: Retrospective cohort study of patients with cancer with unplanned ICU admission. We classified admissions as appropriate or potentially inappropriate according to Society of Critical Care Medicine guidelines. We used logistic regression model to assess factors associated with inappropriateness for ICU admission.Results: From 3384 patients, 663 (19.6%) were classified as potentially inappropriate. They received more invasive mechanical ventilation (25.3% vs 12.5%, P < 0.001) and vasopressors (34.4% vs 30.1%, P = 0.034), had higher ICU [3 (2,6) vs 2 (1,4), P < 0.001] length-of-stay, higher ICU (32.7% vs 8.4%, P < 0.001), hospital (71.9% vs 21.3%, P < 0.001), and one-year mortality (97.6% vs 54.7%, P < 0.001) compared with those considered appropriate. Performance status impairment, more severe organ dysfunctions at admission, metastatic disease, and source of ICU admission were the characteristics associated with intensivist's perception of inappropriateness of ICU admission.Conclusions: These findings may help guide ICU admission policies and triage criteria for end-of-life discussions among hospitalized patients with cancer.
Palavras-chave
Critical Care, Cancer, Outcomes, Admission, Nonbeneficial Treatment, Triage
URI
https://observatorio.fm.usp.br/handle/OPI/58167
Referências
  1. Anesi GL, 2019, LANCET RESP MED, V7, P605, DOI 10.1016/S2213-2600(19)30088-8
  2. Blanch L, 2016, J CRIT CARE, V36, P301, DOI 10.1016/j.jcrc.2016.06.014
  3. Borcoman E, 2019, Ann Oncol, V30, pv732, DOI [10.1093/annonc/mdz265.045, DOI 10.1093/ANNONC/MDZ265.045]
  4. Bos MMEM, 2015, CANCER MED-US, V4, P966, DOI 10.1002/cam4.430
  5. Bos MMEM, 2012, ACTA ONCOL, V51, P897, DOI 10.3109/0284186X.2012.679311
  6. Cardona-Morrell M, 2016, INT J QUAL HEALTH C, V28, P456, DOI 10.1093/intqhc/mzw060
  7. Chang YJ, 2021, ACUTE CRIT CARE, V36, P351, DOI 10.4266/acc.2021.00283
  8. CHARLSON ME, 1987, J CHRON DIS, V40, P373, DOI 10.1016/0021-9681(87)90171-8
  9. Cheung MC, 2015, CANCER-AM CANCER SOC, V121, P3307, DOI 10.1002/cncr.29485
  10. Costa Ramon Teixeira, 2021, Rev. bras. ter. intensiva, V33, P298, DOI [10.5935/0103-507x.20210038, 10.5935/0103-507X.20210038]
  11. de Earp Siqueira AS, 2017, Health Sci J, P11, DOI [10.21767/1791-809x.1000514, DOI 10.21767/1791-809X.1000514, 10.21767/1791-809X.1000514]
  12. Dumas G, 2023, INTENS CARE MED, V49, P345, DOI 10.1007/s00134-023-06988-y
  13. Earle CC, 2008, J CLIN ONCOL, V26, P3860, DOI 10.1200/JCO.2007.15.8253
  14. Ethier JL, 2018, J PALLIAT CARE, V33, P125, DOI 10.1177/0825859718762287
  15. García-Martín E, 2021, SUPPORT CARE CANCER, V29, P3121, DOI 10.1007/s00520-020-05828-9
  16. Gheerbrant H, 2021, BMC CANCER, V21, DOI 10.1186/s12885-020-07706-3
  17. Goldwasser Rosane Sonia, 2018, Rev. bras. ter. intensiva, V30, P347, DOI 10.5935/0103-507X.20180053
  18. Gutierrez C, 2019, J INTENSIVE CARE MED, V34, P55, DOI 10.1177/0885066616686536
  19. Hollinger A, 2019, ANN INTENSIVE CARE, V9, DOI 10.1186/s13613-019-0514-y
  20. Huynh TN, 2013, JAMA INTERN MED, V173, P1887, DOI 10.1001/jamainternmed.2013.10261
  21. Hwe C, 2020, J INTENSIVE CARE MED, V35, P1411, DOI 10.1177/0885066619826044
  22. Li Z, 2019, BMJ OPEN, V9, DOI 10.1136/bmjopen-2018-026309
  23. McNarry AF, 2004, INTENS CARE MED, V30, P325, DOI 10.1007/s00134-003-2072-9
  24. Nassar AP Jr, 2019, J INTENSIVE CARE MED, V34, P811, DOI 10.1177/0885066617716105
  25. Nassar AP, 2021, J GERIATR ONCOL, V12, P106, DOI 10.1016/j.jgo.2020.06.005
  26. Nassar AP, 2020, PLOS ONE, V15, DOI 10.1371/journal.pone.0238124
  27. Nassiff A, 2021, REV LAT-AM ENFERM, V29, DOI 10.1590/1518-8345.4945.3489
  28. Nates JL, 2016, CRIT CARE MED, V44, P1553, DOI 10.1097/CCM.0000000000001856
  29. OKEN MM, 1982, AM J CLIN ONCOL-CANC, V5, P649, DOI 10.1097/00000421-198212000-00014
  30. Patel Jayshil J, 2018, J Intensive Care Soc, V19, P319, DOI 10.1177/1751143718765412
  31. Pujol Varela I, 2020, Oncologic Critical Care, P19, DOI [10.1007/978-3-319-74588-6_3, DOI 10.1007/978-3-319-74588-6_3]
  32. Quenot JP, 2019, PLOS ONE, V14, DOI 10.1371/journal.pone.0222039
  33. Ranzani OT, 2020, INTENS CARE MED, V46, P1030, DOI 10.1007/s00134-020-05963-1
  34. Reddy DRS, 2021, CRIT CARE CLIN, V37, P1, DOI 10.1016/j.ccc.2020.08.001
  35. Rees S, 2020, J INTENSIVE CARE SOC, V21, P79, DOI 10.1177/1751143719832185
  36. Rosa RG, 2020, CRIT CARE MED, V48, P64, DOI 10.1097/CCM.0000000000004024
  37. Schouela N, 2021, INQUIRY-J HEALTH CAR, V58, DOI 10.1177/00469580211028577
  38. Silva CMD, 2023, INTERN EMERG MED, V18, P1191, DOI 10.1007/s11739-023-03216-9
  39. Silva JM, 2010, REV BRAS ANESTESIOL, V60, P20, DOI 10.1590/S0034-70942010000100003
  40. Sin S, 2019, ACUTE CRIT CARE, V34, P46, DOI 10.4266/acc.2018.00388
  41. Soares M, 2010, CRIT CARE MED, V38, P9, DOI 10.1097/CCM.0b013e3181c0349e
  42. Starr LT, 2019, AM J HOSP PALLIAT ME, V36, P913, DOI 10.1177/1049909119848148
  43. Taqi K, 2022, WORLD J SURG ONCOL, V20, DOI 10.1186/s12957-022-02694-z
  44. van der Zee EN, 2021, ANN INTENSIVE CARE, V11, DOI 10.1186/s13613-021-00898-2
  45. van der Zee EN, 2021, PLOS ONE, V16, DOI 10.1371/journal.pone.0252771
  46. Vincent JL, 1996, INTENS CARE MED, V22, P707, DOI 10.1007/BF01709751
  47. Vizzacchi BA, 2024, CRIT CARE MED, V52, P102, DOI 10.1097/CCM.0000000000006070
  48. von Elm E, 2007, LANCET, V370, P1453, DOI 10.1016/S0140-6736(07)61602-X
  49. Zampieri FG, 2021, INTENS CARE MED, V47, P170, DOI 10.1007/s00134-020-06184-2
  50. Zampieri FG, 2018, INTENS CARE MED, V44, P1512, DOI 10.1007/s00134-018-5342-2

Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - ODS/03