Intensive care unit outcomes and prognostic factors of colorectal cancer

重症监护病房治疗结果及结直肠癌预后因素

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Abstract

BACKGROUND: Colorectal cancer (CRC) is one of the most common cancers and CRC patients are among the most common intensive care unit (ICU) admitted cancer patients. However, their prognosis and evaluation methods are rarely studied. AIM: To determine the short-term mortality outcome and identify the potential prognostic factors of CRC cancer patients admitted to the ICU. METHODS: A multicenter cross-sectional study was performed from May 10, 2021 to July 10, 2021 at the ICU departments of 37 cancer specialized hospitals in China, and included patients aged ≥ 14 years with ICU duration ≥ 24 hours. Clinical records of patients with a primary CRC diagnosis were reviewed. Patients were separated into groups according to 90-day survival. Characteristics between groups were compared. Univariate and multivariate regression tests were used to analyze the correlated factors of ICU outcomes. Predictive values of disease severity scores were assessed using receiver operating characteristic curve analysis. RESULTS: In total, 189 CRC patients were included in the study. The 90-day mortality was 12.2%. Patients who died showed differences compared to patients who survived mostly in terms of disease severity and ICU complications. It appears that patients admitted to the ICU from a clinical ward due to emergencies may have a higher risk of mortality while surgical management was associated with better survival. In multivariate analysis, only chemotherapy, elective surgery and conventional oxygen therapy were identified as independently correlated with 90-day mortality. Sequential organ failure assessment and acute physiology and chronic health evaluation II scores had moderate accuracy in predicting short-term mortality. CONCLUSION: ICU admitted CRC patients appear to have low short-term mortality which requires further confirmation in prospective studies. The prognostic tools for these patients need further optimization.

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