Predictors of short-term mortality in critically ill patients with solid malignancies

Azoulay, Élie; Moreau, Delphine; Alberti, Corrine; Leleu, Ghislaine; Adrie, Christophe; Barboteu, M; Cottu, P.; Lévy, Vincent; Gall, J. R. Le; Schlemmer, Benoı̂t

doi:10.1007/s001340051350

Cited by 168 publications

(102 citation statements)

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“…Neutropenia was not found to affect mortality in cancer patients with Streptococcus pneumoniae bacteraemia [12], as well as bacteraemia caused by other micro-organisms [13]. In line with these data, five other studies evaluating patients hospitalised in ICU showed neutropenia to not be independently associated with mortality in cancer patients with different sites of infection [14][15][16][17][18]. During the past decades, the attention in management of infections in cancer patients has focused on fever and neutropenia [19].…”

Section: Discussionmentioning

confidence: 87%

The role of neutropenia on outcomes of cancer patients with community-acquired pneumonia

et al. 2008

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Although the presence of neutropenia may predispose cancer patients to develop community-acquired pneumonia, the role of neutropenia on their outcomes has not been investigated. The purpose of the present study was to compare clinical outcomes of cancer community-acquired pneumonia patients with and without neutropenia.Patients with cancer, identified in the Community-Acquired Pneumonia Organization database, were divided into two groups according to the type of cancer and the presence of neutropenia: patients with solid cancer without neutropenia versus those with functional or absolute neutropenia. Among the 3,106 community-acquired pneumonia patients enrolled, 135 had cancer without neutropenia and 75 had cancer with neutropenia.No significant difference was found between patients with and without neutropenia regarding mean time to clinical stability (5.4¡2.7 versus 4.9¡2.7 days, respectively), mean length of hospital stay (9.2¡7.7 versus 9.9¡9.6 days) and in-hospital mortality (18 versus 15%, respectively). Using a multiple logistic regression model, neutropenia was not associated with mortality in cancer patients when adjusting for significant covariates (odds ratio 1.30).Lack of neutropenia, during the initial evaluation of a cancer community-acquired pneumonia patient, should not be considered an indicator of better clinical outcome.

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Section: Discussionmentioning

confidence: 87%

The role of neutropenia on outcomes of cancer patients with community-acquired pneumonia

et al. 2008

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“…Table 1 Principal admission diagnosis in ABMT/AHSCT patients (n ¼ 44) The outcome of allogeneic BM transplant patients with acute critical illness is described P Depuydt et al Short-term outcome in critically ill patients with solid cancer or haematological malignancy has been shown to be mainly predicted by the number of failing organs, rather than by the underlying neoplasy characteristics. 8,9,[23][24][25] Acute respiratory failure (ARF) with need for MV is the most common reason for ICU referral in these patients and is a very strong predictor for poor outcome. Moreover, whereas prognosis for mechanically ventilated cancer patients (including haematological patients) in general has improved over the last two decades, this trend has not been observed in ABMT/AHSCT patients, in whom ICU and inhospital mortality rates have not reduced below 80%.…”

Section: Discussionmentioning

confidence: 99%

Outcome in critically ill patients with allogeneic BM or peripheral haematopoietic SCT: a single-centre experience

Depuydt

Kerre

Noens

et al. 2010

Bone Marrow Transplant

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Outcome in haematological patients who develop critical illness has significantly improved over the last two decades, but less so in allogeneic BMT recipients. We prospectively investigated the outcome of 44 haematological patients with allogeneic BM or haematopoietic SCT (ABMT/AHSCT) requiring admission to the intensive care unit (ICU) of Ghent University Hospital between January 2000 and December 2007. We related outcome to the cause of critical illness, which was categorized as documented or clinically suspected bacterial infection, non-bacterial infection and non-infectious disease. Mechanical ventilation was required in 32 patients, and 12 patients received renal replacement therapy. Overall ICU-mortality, in-hospital mortality and 6-month mortality rates were 61, 75 and 80%, respectively. Hospital mortality rates in patients with bacterial infection (n = 14), non-bacterial infection (n = 13) and non-infectious disease (n = 17) were 43, 85 and 94% (P = 0.003). After adjustment for severity of illness sequential organ failure assessment (SOFA) score, bacterial infection (odds ratio 0.06, 0.01-0.36, P = 0.002) was associated with significantly lower odds for hospital mortality. On the basis of our experience, ICU referral of ABMT/AHSCT patients is justifiable, as an acceptable fraction of these patients have longer-term survival. Documented or clinically suspected bacterial infection as the cause of critical illness is associated with better prognosis in comparison with other causes

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“…In fact, approximately 10 to 50 percent of cancer patients may experience AKI whom about 10 to more than 30% of them might need renal replacement therapy (RRT) during their hospitalization in intensive care unit (ICU) (20,21). In addition, melanoma, breast, lung, esophagus and colon cancers are the most common malignancies that could metastasize to kidney, leading to large, solitary mass lesions (22).…”

Section: Acute Kidney Injury In Cancersmentioning

confidence: 99%

Impact of cancers on the kidney function and structure; an ignored entity

Davoodi¹,

Bahadoram²,

Bahadoram³

et al. 2018

J Renal Inj Prev

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Important declines have been observed in urological cancer-related mortality in recent decades, mainly due to improvements in treatments of prostate cancer, less exposure to tobacco smoking as well as occupational carcinogens of kidney and bladder. However, because of global population ageing, age-related urinary tract cancers are expected to increase in the near future despite improved primary prevention, early detection and more efficient treatment. In this article, renal cell carcinoma (RCC), kidney transplantation, cancer and acute kidney injury (AKI), lung cancer and chronic kidney disease (CKD), breast cancer, prostate cancer, cervix cancer and brain cancer and their associations with kidney function and structure have been discussed. In conclusion, kidney and cancers have interaction with each other. Kidney carcinoma can be metastasizing to other organs as well as other cancer to kidney. Therefore, it is recommended to consider the potential effect of kidney functions and interaction with other cancers in each malignancy.

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Predictors of short-term mortality in critically ill patients with solid malignancies

Abstract: When transfer to an ICU is considered an option by patients and physicians, 30-day mortality is better estimated by an evaluation of acute organ dysfunction than by the characteristics of the underlying malignancy.

Cited by 168 publications

References 0 publications

The role of neutropenia on outcomes of cancer patients with community-acquired pneumonia

The role of neutropenia on outcomes of cancer patients with community-acquired pneumonia

Outcome in critically ill patients with allogeneic BM or peripheral haematopoietic SCT: a single-centre experience

Impact of cancers on the kidney function and structure; an ignored entity

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