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Research article
The Effect of the Underlying Malignancy on Short- and Medium-Term Survival of Critically Ill Patients Admitted to the Intensive Care Unit : A Retrospective Analysis Based on Propensity Score Matching
Xuezhong Xing
Cancer hospital/Chinese academy of medical sciences
Corresponding Author
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Background Advances in oncology led to a substantial increase in the number of patients requiring admission to the ICU. It is significant to confirm which cancer critical patients can benefit from the ICU care service like noncancer patients.
Methods An observational retrospective cohort study using intensive care unit (ICU) admissions of Medical Information Mart for Intensive Care III from the Beth Israel Deaconess Medical Center in Boston, MA, USA between 2001 and 2012 was conducted. Propensity score matching was used to reduce the imbalance between two matched cohorts. ICU patients with cancer were compared with those without cancer in terms of patients’ characteristics and survival.
Results There were 38,508 adult patients admitted to ICUs during the period. The median age was 65 years (IQR, 52-77) and 8,308 (21.8%) had an underlying malignancy diagnosis. The noncancer group had a significant survive advantage at the point of 28-day, 90-day, 365-day and 1095-day after ICU admission compared with cancer group (P < 0.001 for all) after PSM. Subgroup analysis showed that the diagnosis of malignancy didn’t decrease 28-day and 90-day survive when patients’ age ≥65-year, patients in surgical intensive care unit or cardiac surgery recovery unit or traumatic surgical intensive care unit, elective admission, patients with renal replacement therapy or vasopressor support (P > 0.05 for all).
Conclusions Malignancy is a common diagnosis among ICU patients. Patients without cancer have a survive advantage compared with patients with cancer in the short- and medium-term. However, in selected groups, cancer critical patients can benefit from the ICU care service like noncancer patients in the short-term.
Keywords
Malignancy, Intensive care unit, Critical illness, Prognosis
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CURRENT STATUS: Under Revision
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Posted 17 Sep, 2020
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On 30 Nov, 2020
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On 27 Nov, 2020
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Received 27 Nov, 2020
Review #1 received
Received 01 Oct, 2020
Reviewers invited
Invitations sent on 30 Sep, 2020
Reviewer #1 agreed
On 30 Sep, 2020
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On 17 Sep, 2020
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On 15 Sep, 2020
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On 14 Sep, 2020
First submitted
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This preprint is under consideration at BMC Cancer. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
The Effect of the Underlying Malignancy on Short- and Medium-Term Survival of Critically Ill Patients Admitted to the Intensive Care Unit : A Retrospective Analysis Based on Propensity Score Matching
Xuezhong Xing
Cancer hospital/Chinese academy of medical sciences
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 17 Sep, 2020
No community comments so far
Editorial decision: Major revision
On 30 Nov, 2020
Reviewer #2 agreed
On 27 Nov, 2020
Review #2 received
Received 27 Nov, 2020
Review #1 received
Received 01 Oct, 2020
Reviewers invited
Invitations sent on 30 Sep, 2020
Reviewer #1 agreed
On 30 Sep, 2020
Editor assigned
On 17 Sep, 2020
Submission checks complete
On 15 Sep, 2020
Editor invited
On 14 Sep, 2020
First submitted
On 21 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background Advances in oncology led to a substantial increase in the number of patients requiring admission to the ICU. It is significant to confirm which cancer critical patients can benefit from the ICU care service like noncancer patients.
Methods An observational retrospective cohort study using intensive care unit (ICU) admissions of Medical Information Mart for Intensive Care III from the Beth Israel Deaconess Medical Center in Boston, MA, USA between 2001 and 2012 was conducted. Propensity score matching was used to reduce the imbalance between two matched cohorts. ICU patients with cancer were compared with those without cancer in terms of patients’ characteristics and survival.
Results There were 38,508 adult patients admitted to ICUs during the period. The median age was 65 years (IQR, 52-77) and 8,308 (21.8%) had an underlying malignancy diagnosis. The noncancer group had a significant survive advantage at the point of 28-day, 90-day, 365-day and 1095-day after ICU admission compared with cancer group (P < 0.001 for all) after PSM. Subgroup analysis showed that the diagnosis of malignancy didn’t decrease 28-day and 90-day survive when patients’ age ≥65-year, patients in surgical intensive care unit or cardiac surgery recovery unit or traumatic surgical intensive care unit, elective admission, patients with renal replacement therapy or vasopressor support (P > 0.05 for all).
Conclusions Malignancy is a common diagnosis among ICU patients. Patients without cancer have a survive advantage compared with patients with cancer in the short- and medium-term. However, in selected groups, cancer critical patients can benefit from the ICU care service like noncancer patients in the short-term.
Figure 1
Figure 2
Figure 3