Author/Authors :
Na, Soo Jin Department of Critical Care Medicine - Samsung Medical Center - Sungkyunkwan University School of Medicine, Seoul , Ha, Tae Sun Department of Surgery - Soonchunhyang University Bucheon Hospital, Bucheon , Koh, Younsuck Department of Medicine - Asan Medical Center - University of Ulsan College of Medicine, Seoul , Suh, Gee Young Department of Critical Care Medicine - Samsung Medical Center - Sungkyunkwan University School of Medicine, Seoul , Koh, Shin Ok Department of Anesthesiology and Pain Medicine - Anesthesia and Pain Research Institute - Yonsei University College of Medicine, Seoul , Lim, Chae-Man Department of Medicine - Asan Medical Center - University of Ulsan College of Medicine, Seoul , Choi, Won-Il Department of Medicine - Dongsan Hospital - Keimyung University, Daegu , Lee, Young-Joo Department of Anesthesiology and Pain Medicine - Ewha Womans University Mokdong Hospital, Seoul , Kim, Seok Chan Department of Medicine - Seoul St. Mary’s Hospital - College of Medicine - Catholic University of Korea, Seoul , Chon, Gyu Rak Department of Medicine - Chungju Hospital - Konkuk University School of Medicine, Chungju , Kim, Je Hyeong Department of Critical Care Medicine - Korea University Ansan Hospital, Ansan , Kim, Jae Yeol Department of Medicine - Chung-Ang University College of Medicine, Seoul , Lim, Jaemin Department of Medicine - Gangneung Asan Hospital - University of Ulsan Medical College of Medicine, Gangneung , Park, Sunghoon Department of Pulmonary - Allergy and Critical Care Medicine - Hallym University Sacred Heart Hospital, Anyang , Kim, Ho Cheol Department of Medicine - College of Medicine - Gyeongsang Institute of Health Sciences - Gyeongsang National University, Jinju , Lee, Jin Hwa Department of Medicine - Ewha Womans University School of Medicine, Seoul , Lee, Ji Hyun Department of Medicine - CHA Bundang Hospital - CHA University, Seongnam , Park, Jisook Department of Multimedia - Seoul Women’s University, Seoul , Cho, Juhee Sungkyunkwan University School of Medicine - Seoul, Korea , Jeon, Kyeongman Department of Critical Care Medicine - Samsung Medical Center - Sungkyunkwan University School of Medicine, Seoul
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.
