Apresentação

How to predict extubation failure?

ROSELAINE PINHEIRO DE OLIVEIRA, CASSIANO TEIXEIRA, RICARDO VIEGAS CREMONESE, NILTON BRANDAO DA SILVA, LUIS GUILHERME ALEGRETTI BORGES, AUGUSTO SAVI, SILVIA REGINA RIOS VIEIRA, FERNANDA CALLEFE MOREIRA, TULIO FREDERICO TONIETTO, JOSE HERVE DIEL BARTH

Em: ESICM 22nd Annual Congress , 2009, Viena. (Poster Eletrônico)

Motivo: Produção Colaborador HMV

Setor HMV: CTI Adulto

Área da saúde: Medicina Intensiva

Resumo: Abstract INTRODUCTION. Cancer patients represent a large proportion of ICU population, as malignancies are becoming increasingly common. In a recent large multicentre observational study in European ICUs, 15% of ICU patients had malignancy. Studies have reported high mortality rates for cancer patients in ICU, especially when they had neutropenia, required mechanical ventilation and renal replacement therapy, but advances in oncological supportive care have improved survival rates in these patients, and many of them can now be cured or have their disease controlled. OBJECTIVES. We designed this study to assess if cancer as cause of ICU admission is related to worse prognosis than non-cancer patients. METHODS. This is a retrospective cohort study including all patients admitted in a 31 beds general ICU over a period of 5 years. Data were collected from a database witch included characteristics, treatment and outcomes of patients from their admission to death or hospital discharge. RESULTS. We included 2997 patients, 606 (20%) of them had a malignancy, 567 (93%) had solid tumor and 39 (7%) had haematological cancer. Solid cancer patients were younger than non-cancer patients (62±15 vs. 68±5, p< 0.001). There was no difference in age between patients with haematological malignancies and non-cancer patients (63±15 vs. 68±5, p=0.95). Patients with haematological cancer were more severely ill than solid cancer and non-cancer patients at admission, as assessed by higher APACHE II score, respectively (12±5 vs. 21±6 vs. 15±7, p< 0,001). In comparison to non-cancer patients, haematological cancer patients had sepsis more frequently (13% vs. 51%, p< 0.001) and needed mechanical ventilation more often (34% vs. 56%, p=0.005) and for longer period (8±12 vs. 11±12, p=0.031). These patients also had a longer ICU stay (8±20 vs. 15±19, p=0.087) and higher hospital mortality compared to patients without cancer (39% vs. 10%, p< 0.001). Solid tumor patients had lower mortality rates than non-cancer patients (7% vs. 10%, p< 0.001). CONCLUSION. In accordance to previous studies, haematological cancer patients in our study had the highest mortality. We found that solid tumor patients can have a better prognosis than non-cancer patients admitted to ICU. The limitation of this result is that we did not discriminate the type and stage of the cancer among those with solid tumor.

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