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Identifier

000449916

Title

Έκβαση ασθενών με νεοπλασία συμπαγών οργάνων και αιματολογικές κακοήθειες που νοσηλεύονται σε ΜΕΘ : Αναδρομική μονοκεντρική μελέτη παρατήρησης

Alternative Title

Outcome of patients with solid organ cancer and haematological malignancies admitted to intensive care unit

Author

Βιδάκη, Μαρία

Thesis advisor

Κονδύλη, Ευμορφία

Reviewer

Ακουμιανάκη, Ευαγγελία
Νύκταρη, Βασιλεία

Abstract

The effectiveness of intensive care unit (ICU) treatment for cancer patients remains controversial. Advances in anti-cancer and supportive care have led to significant improvements in the outcome of cancer patients in the ICU. Improved cancer treatments and supportive organ management have helped improve survival rates. As a result, the number of cancer patients who need admission to the ICU is increasing. Often, cancer patients have poor functional status and are vulnerable. Until now, no specific disease severity scoring system could reliably predict the outcome of cancer patients in critical condition, and no specific scoring systems or prognostic factors for survival have been reported. The main determinants of mortality and prognosis are the number of organs with insufficiency, the need for mechanical ventilation (especially for acute respiratory distress syndrome), the need for vasoactive agents (> 4 hours) and treatments prior to ICU admission. The aim of this study was to identify risk factors that predict the prognosis of patients with solid and haematological neoplasms in the ICU. All admissions to the ICU of patients with solid cancer and hematological neoplasms at the University Hospital of Heraklion, Crete for 2 years (January 2019 to December 2021) were analyzed through a monocentric retrospective observational study. Approved by the Ethics Committee of the University Hospital for control and publication of information from patient records. One hundred and thirty-two patients met the criteria of the study 60.6% were men. A quarter of all cancer patients who needed ICU admission ended up in ICU during treatment (36.2%). In-hospital mortality was 62.3%. The main factors associated with patient outcome were duration of mechanical ventilation, age, BMI, previous functional status, chronic respiratory pneumonia followed by diabetes mellitus, chronic renal failure, autoimmune, dyslipidemia etc. Additional prognostic indicators were the Glasgow Coma Scale (GCS), the severity of patients expressed with but also the exchange of blood gases (PO2, PH, PCO2) and the value of hemoglobin at admission. In particular, patients with statistically higher average in the SOFA score and in the APACHE score showed higher mortality rates in the ICU compared to those who survived with a corresponding pattern for the averages.

Language

Greek, English

Subject

Oncology

SOFA

Καρκίνος

Ογκολογικοί ασθενείς

Issue date

2022-07-29

Collection

School/Department--School of Medicine--Department of Medicine--Post-graduate theses

Type of Work--Post-graduate theses