We have located links that may give you full text access.
EVALUATION STUDY
JOURNAL ARTICLE
OBSERVATIONAL STUDY
RESEARCH SUPPORT, NON-U.S. GOV'T
Effect of Early Intervention on Long-Term Outcomes of Critically Ill Cancer Patients Admitted to ICUs.
Critical Care Medicine 2015 July
OBJECTIVES: The objective of this observational study was to evaluate whether early intervention was associated with improved long-term outcomes in critically ill patients with cancer.
DESIGN: Retrospective analysis with prospectively collected data.
SETTING: A university-affiliated, tertiary referral hospital.
PATIENTS: Consecutive critically ill cancer patients who were managed by a medical emergency team before ICU admission between January 2010 and December 2012.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: During the study period, 525 critically ill cancer patients were admitted to the ICU with respiratory failure (41.7%) and severe sepsis or septic shock (40.6%) following medical intervention by a medical emergency team. Of 356 ICU survivors, 161 (45.2%) received additional treatment for cancer after ICU discharge. Mortality was 66.1% at 6 months and 72.8% at 1 year. Median time from physiological derangement to intervention before ICU admission was significantly shorter in 1-year survivors (1.3 hr; interquartile range, 0.5-4.8 hr) than it was in nonsurvivors (2.9 hr; interquartile range, 0.8-9.6 hr) (p< 0.001). Additionally, the early intervention (≤ 1.5 hr) group had a lower 30-day mortality rate than the late intervention (> 1.5 hr) group (29.0% vs 55.3%; p < 0.001) and a similar difference in mortality rate was observed up to 1 year. Other factors associated with 1-year mortality were illness severity, performance status, malignancy status, presence of more than three abnormal physiological variables, time from derangement to ICU admission, and the need for mechanical ventilation. Even after adjusting for potential confounding factors, early intervention was significantly associated with 1-year mortality (adjusted hazard ratio, 0.456; 95% CI, 0.348-0.597; p < 0.001).
CONCLUSION: Early intervention for clinical derangement on general wards was significantly associated with long-term outcomes in critically ill cancer patients.
DESIGN: Retrospective analysis with prospectively collected data.
SETTING: A university-affiliated, tertiary referral hospital.
PATIENTS: Consecutive critically ill cancer patients who were managed by a medical emergency team before ICU admission between January 2010 and December 2012.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: During the study period, 525 critically ill cancer patients were admitted to the ICU with respiratory failure (41.7%) and severe sepsis or septic shock (40.6%) following medical intervention by a medical emergency team. Of 356 ICU survivors, 161 (45.2%) received additional treatment for cancer after ICU discharge. Mortality was 66.1% at 6 months and 72.8% at 1 year. Median time from physiological derangement to intervention before ICU admission was significantly shorter in 1-year survivors (1.3 hr; interquartile range, 0.5-4.8 hr) than it was in nonsurvivors (2.9 hr; interquartile range, 0.8-9.6 hr) (p< 0.001). Additionally, the early intervention (≤ 1.5 hr) group had a lower 30-day mortality rate than the late intervention (> 1.5 hr) group (29.0% vs 55.3%; p < 0.001) and a similar difference in mortality rate was observed up to 1 year. Other factors associated with 1-year mortality were illness severity, performance status, malignancy status, presence of more than three abnormal physiological variables, time from derangement to ICU admission, and the need for mechanical ventilation. Even after adjusting for potential confounding factors, early intervention was significantly associated with 1-year mortality (adjusted hazard ratio, 0.456; 95% CI, 0.348-0.597; p < 0.001).
CONCLUSION: Early intervention for clinical derangement on general wards was significantly associated with long-term outcomes in critically ill cancer patients.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices 
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app