Acute Crit Care.  2018 Aug;33(3):121-129. 10.4266/acc.2018.00143.

Characteristics and Clinical Outcomes of Critically Ill Cancer Patients Admitted to Korean Intensive Care Units

Affiliations
  • 1Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kjeon@skku.edu
  • 2Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
  • 3Division of Pulmonary and Critical Care Medicine, Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 4Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 5Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
  • 6Division of Pulmonary and Critical Care Medicine, Department of Medicine, Dongsan Hospital, Keimyung University, Daegu, Korea.
  • 7Department of Anesthesiology and Pain Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea.
  • 8Division of Pulmonary and Critical Care Medicine, Department of Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea.
  • 9Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea.
  • 10Department of Critical Care Medicine, Korea University Ansan Hospital, Ansan, Korea.
  • 11Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
  • 12Division of Pulmonary and Critical Care Medicine, Department of Medicine, Gangneung Asan Hospital, University of Ulsan Medical College of Medicine, Gangneung, Korea.
  • 13Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
  • 14Division of Pulmonary and Critical Care Medicine, Department of Medicine, College of Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University, Jinju, Korea.
  • 15Division of Pulmonary and Critical Care Medicine, Department of Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
  • 16Division of Pulmonary and Critical Care Medicine, Department of Medicine, CHA Bundang Hospital, CHA University, Seongnam, Korea.
  • 17Department of Multimedia, Seoul Women's University, Seoul, Korea.
  • 18Samsung Advanced Institute of Health Science and Technology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

BACKGROUND
The objective of this study was to investigate the characteristics and clinical outcomes of critically ill cancer patients admitted to intensive care units (ICUs) in Korea.
METHODS
This was a retrospective cohort study that analyzed prospective collected data from the Validation of Simplified Acute Physiology Score 3 (SAPS3) in Korean ICU (VSKI) study, which is a nationwide, multicenter, and prospective study that considered 5,063 patients from 22 ICUs in Korea over a period of 7 months. Among them, patients older than 18 years of age who were diagnosed with solid or hematologic malignancies prior to admission to the ICU were included in the present study.
RESULTS
During the study period, a total of 1,762 cancer patients were admitted to the ICUs and 833 of them were deemed eligible for analysis. Six hundred fifty-eight (79%) had solid tumors and 175 (21%) had hematologic malignancies, respectively. Respiratory problems (30.1%) was the most common reason leading to ICU admission. Patients with hematologic malignancies had higher Sequential Organ Failure Assessment (12 vs. 8, P < 0.001) and SAPS3 (71 vs. 69, P < 0.001) values and were more likely to be associated with chemotherapy, steroid therapy, and immunocompromised status versus patients with solid tumors. The use of inotropes/vasopressors, mechanical ventilation, and/or continuous renal replacement therapy was more frequently required in hematologic malignancy patients. Mortality rates in the ICU (41.7% vs. 24.6%, P < 0.001) and hospital (53.1% vs. 38.6%, P=0.002) were higher in hematologic malignancy patients than in solid tumor patients.
CONCLUSIONS
Cancer patients accounted for one-third of all patients admitted to the studied ICUs in Korea. Clinical characteristics were different according to the type of malignancy. Patients with hematologic malignancies had a worse prognosis than did patients with solid tumor.

Keyword

cancer; critical care; epidemiology; hematologic neoplasm; mortality

MeSH Terms

Cohort Studies
Critical Care*
Critical Illness*
Drug Therapy
Epidemiology
Hematologic Neoplasms
Humans
Intensive Care Units*
Korea
Mortality
Physiology
Prognosis
Prospective Studies
Renal Replacement Therapy
Respiration, Artificial
Retrospective Studies
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