Clinical characteristics and outcomes of critically ill cancer patients with septic shock

被引:17
作者
Namendys-Silva, S. A. [1 ,2 ]
Gonzalez-Herrera, M. O. [1 ]
Texcocano-Becerra, J. [1 ]
Herrera-Gomez, A. [3 ]
机构
[1] Inst Nacl Cancerol, Dept Crit Care Med, Mexico City 14080, DF, Mexico
[2] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Crit Care Med, Mexico City, DF, Mexico
[3] Inst Nacl Cancerol, Dept Surg Oncol, Mexico City 14080, DF, Mexico
关键词
INTENSIVE-CARE-UNIT; SHORT-TERM MORTALITY; PROGNOSTIC-FACTORS; SEVERE SEPSIS; EPIDEMIOLOGY; ADMISSION; MANAGEMENT; PREDICTORS; SEVERITY; SURVIVAL;
D O I
10.1093/qjmed/hcq260
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Design: Prospective, observational cohort study. Methods: Medical-surgical intensive care unit (ICU) at the Instituto Nacional de Cancerologia located in Mexico City from January 2008 to February 2010. There were no interventions. Eighty-two consecutive cancer patients with septic shock aged over 18 years were prospectively included and evaluated. Results: During the study period, 620 critically ill cancer patients were admitted to ICU. Ninety-four patients were evaluated for septic shock at the request of ward onco-hematologists or surgeon oncologist responsible for the patient. After being evaluated by the intensivists, 82 patients were admitted to the ICU. Of the 82 patients, 56 (68.3%) had solid tumours and 26 (31.7%) had hematological malignancy. The most frequent sites of infection were: abdominal (57.3%) and respiratory (35.8%). Cultures were positive in 41 (50%) patients. The 63.4% of the patients had three or more organ dysfunctions on the day of their admission to the ICU. Cox multivariate analysis identified the Sequential Organ Failure Assessment (SOFA) score [hazard ratio (HR): 1.11; 95% confidence interval (95% CI): 1.02-1.19, P = 0.008) and performance status (PS) epsilon 2 (HR: 1.84; 95% CI: 1.03-3.29, P = 0.040) as independent predictors of death to 3 months. The ICU mortality rate was 41.5% (95% CI: 31-52%). Conclusion: The variables associated with increased mortality were the degree of organ dysfunction determined by SOFA score at ICU admission and PS epsilon 2.
引用
收藏
页码:505 / 511
页数:7
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