Journal Article

Elderly patients with cancer admitted to intensive care unit: A multicenter study in a middle-income country

Salluh, Jorge Ibrahin Figueira, Silva, Amilton, Tommasi, Edmundo de Oliveira, Nassar Junior, Antonio Paulo, Bozza, Fernando Augusto, Pinto, Jorge Eduardo da Silva Soares, Romano, Edson, Cruz, Bruno Azevedo da, Santos, Robson Correa, de Moraes, Ana Paula Pierre, de Freitas, Flávio Geraldo Rezende, Faria, Guilherme Brenande Alves, Trevisani, Mariane da Silva, Bettim, Barbara Beltrame, Soares, Marcio, Zampieri, Fernando Godinho, Caruso, Pedro, Carvalho, José Albani, Ramos, Silvia Regina, Silva, Ulysses V. Andrade e

2020

Overview

Very elderly critically ill patients (ie, those older than 75 or 80 years) are an increasing population in intensive care units. However, patients with cancer have encompassed only a minority in epidemiological studies of very old critically-ill patients. We aimed to describe clinical characteristics and identify factors associated with hospital mortality in a cohort of patients aged 80 or older with cancer admitted to intensive care units (ICUs). This was a retrospective cohort study in 94 ICUs in Brazil. We included patients aged 80 years or older with active cancer who had an unplanned admission. We performed a mixed effect logistic regression model to identify variables independently associated with hospital mortality. Of 4604 included patients, 1807 (39.2%) died in hospital. Solid metastatic (OR = 2.46; CI 95%, 2.01-3.00), hematological cancer (OR = 2.32; CI 95%, 1.75-3.09), moderate/severe performance status impairment (OR = 1.59; CI 95%, 1.33-1.90) and use of vasopressors (OR = 4.74; CI 95%, 3.88-5.79), mechanical ventilation (OR = 1.54; CI 95%, 1.25-1.89) and renal replacement (OR = 1.81; CI 95%, 1.29-2.55) therapy were independently associated with increased hospital mortality. Emergency surgical admissions were associated with lower mortality compared to medical admissions (OR = 0.71; CI 95%, 0.52-0.96). Hospital mortality rate in very elderly critically ill patients with cancer with unplanned ICU admissions are lower than expected a priori. Cancer characteristics, performance status impairment and acute organ dysfunctions are associated with increased mortality.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Biology and Life Sciences / Blood cancer / Breast cancer / Cancer / Cancer patients / Care and treatment / Demographic aspects / Education / Elderly patients / Emergency medical services / Epidemiology / Hematology / Hospitals / Impairment / Intensive care / Intensive care units / Kidney cancer / Mechanical ventilation / Medicine and Health Sciences / Metastases / Metastasis / Mortality / Older people / Patient outcomes / Patients / Population growth / Prostate cancer / Regression models / Renal replacement therapy / Statistics / Supervision / Variables / Ventilation / Ventilators