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首页> 外文期刊>Medical oncology >Who should be admitted to the intensive care unit? The outcome of intensive care unit admission in stage IIIB-IV lung cancer patients
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Who should be admitted to the intensive care unit? The outcome of intensive care unit admission in stage IIIB-IV lung cancer patients

机译：谁应该入住重症监护病房？ IIIB-IV期肺癌患者重症监护室入院的结果

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Critical care for advanced lung cancer patients is still controversial, and the appropriate method for the selection of patients who may benefit from intensive care unit (ICU) care is not clearly defined. We retrospectively reviewed the medical records of stage IIIB-IV lung cancer patients admitted to the medical ICU of a university hospital in Korea between 2003 and 2011. Of 95 patients, 64 (67 %) had Eastern Cooperative Oncology Group (ECOG) performance status (PS) C2, and 79 (84 %) had non-small-cell lung cancer. In total, 28 patients (30 %) were newly diagnosed or were receiving first-line treatment, and 22 (23 %) were refractory or bedridden. Mechanical ventilation was required in 85 patients (90 %), and ICU mortality and hospital mortality were 57 and 78 %, respectively. According to a multivariate analysis, a PaO_2/FiO_2 ratio <150 [odds ratio (OR) = 5.51, 95 % confidence interval (CI) 2.10-14.48,p = 0.001] was independently associated with ICU mortality, and an ECOG PS C2 (OR = 9.53, 95 % CI 2.03-4.85, p = 0.004) and a need for vasoactive agents (OR = 6.94, 95 % CI 1.61-29.84, p = 0.009) were independently associated with hospital mortality. Refractory or bedridden patients (n = 22) showed significantly poorer overall survival (11.0 vs. 29.0 days, p = 0.005). Among 21 patients who were discharged from the hospital, 11 (52 %) received further chemotherapy. Certain advanced lung cancer patients may benefit from ICU management. However, refractory patients and patients with a poor PS do not seem to benefit from ICU care. Oncologists should try to discuss palliative care and end-of-life issues in advance to avoid futile care.
机译：对于晚期肺癌患者的重症监护仍存在争议，并且对于可能从重症监护病房（ICU）监护中受益的患者的选择方法尚未明确定义。我们回顾性回顾了2003年至2011年间在韩国一家大学医院的ICU住院的IIIB-IV期肺癌患者的病历。在95名患者中，有64名（67％）的患者表现为东部合作肿瘤小组（ECOG）的表现状态（ PS）C2，其中79例（84％）患有非小细胞肺癌。新诊断或接受一线治疗的患者共28例（30％），难治性或卧床不起的患者22例（23％）。 85名患者（90％）需要机械通气，ICU死亡率和医院死亡率分别为57％和78％。根据多变量分析，PaO_2 / FiO_2比率<150 [奇数比率（OR）= 5.51，95％置信区间（CI）2.10-14.48，p = 0.001]与ICU死亡率和ECOG PS C2（ OR = 9.53，95％CI 2.03-4.85，p = 0.004）和需要血管活性药物（OR = 6.94，95％CI 1.61-29.84，p = 0.009）与医院死亡率独立相关。难治性或卧床不起的患者（n = 22）表现出较差的总生存期（11.0 vs. 29.0天，p = 0.005）。在出院的21位患者中，有11位（52％）接受了进一步的化疗。某些晚期肺癌患者可能会受益于ICU管理。但是，难治性患者和PS较差的患者似乎并未从ICU护理中受益。肿瘤学家应尽早讨论姑息治疗和临终问题，以避免徒劳的治疗。

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