Characteristics and Clinical Outcomes of Critically Ill Cancer Patients Admitted to Korean Intensive Care Units

Soo Jin Na¹, Tae Sun Ha², Younsuck Koh³, Gee Young Suh^{1

4}, Shin Ok Koh⁵, Chae-Man Lim³, Won-Il Choi⁶, Young-Joo Lee⁷, Seok Chan Kim⁸, Gyu Rak Chon⁹, Je Hyeong Kim¹⁰, Jae Yeol Kim¹¹, Jaemin Lim¹², Sunghoon Park¹³, Ho Cheol Kim¹⁴, Jin Hwa Lee¹⁵, Ji Hyun Lee¹⁶, Jisook Park¹⁷, Juhee Cho¹⁸, Kyeongman Jeon^{1

4}; Validation of Simplified Acute Physiology Score 3 in Korean Intensive care unit (VSKI) study group; Korean Study Group On Respiratory Failure (KOSREF)

Affiliations

¹ Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
² Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
³ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
⁴ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
⁵ Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
⁶ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Dongsan Hospital, Keimyung University, Daegu, Korea.
⁷ Department of Anesthesiology and Pain Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea.
⁸ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea.
⁹ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea.
¹⁰ Department of Critical Care Medicine, Korea University Ansan Hospital, Ansan, Korea.
¹¹ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
¹² Division of Pulmonary and Critical Care Medicine, Department of Medicine, Gangneung Asan Hospital, University of Ulsan Medical College of Medicine, Gangneung, Korea.
¹³ Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
¹⁴ Division of Pulmonary and Critical Care Medicine, Department of Medicine, College of Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University, Jinju, Korea.
¹⁵ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
¹⁶ Division of Pulmonary and Critical Care Medicine, Department of Medicine, CHA Bundang Hospital, CHA University, Seongnam, Korea.
¹⁷ Department of Multimedia, Seoul Women's University, Seoul, Korea.
¹⁸ Samsung Advanced Institute of Health Science and Technology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

PMID: 31723875
PMCID: PMC6786698
DOI: 10.4266/acc.2018.00143

Characteristics and Clinical Outcomes of Critically Ill Cancer Patients Admitted to Korean Intensive Care Units

Soo Jin Na et al. Acute Crit Care. 2018 Aug.

. 2018 Aug;33(3):121-129.

doi: 10.4266/acc.2018.00143. Epub 2018 Aug 31.

Authors

Affiliations

¹ Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
² Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
³ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
⁴ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
⁵ Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
⁶ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Dongsan Hospital, Keimyung University, Daegu, Korea.
⁷ Department of Anesthesiology and Pain Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea.
⁸ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea.
⁹ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea.
¹⁰ Department of Critical Care Medicine, Korea University Ansan Hospital, Ansan, Korea.
¹¹ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
¹² Division of Pulmonary and Critical Care Medicine, Department of Medicine, Gangneung Asan Hospital, University of Ulsan Medical College of Medicine, Gangneung, Korea.
¹³ Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
¹⁴ Division of Pulmonary and Critical Care Medicine, Department of Medicine, College of Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University, Jinju, Korea.
¹⁵ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
¹⁶ Division of Pulmonary and Critical Care Medicine, Department of Medicine, CHA Bundang Hospital, CHA University, Seongnam, Korea.
¹⁷ Department of Multimedia, Seoul Women's University, Seoul, Korea.
¹⁸ Samsung Advanced Institute of Health Science and Technology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

PMID: 31723875
PMCID: PMC6786698
DOI: 10.4266/acc.2018.00143

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.

Keywords: cancer; critical care; epidemiology; hematologic neoplasm; mortality.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

**Figure 1.**
A schematic of study participant flow. ICU: intensive care unit.

**Figure 2.**
A comparison of intensive care unit (ICU) and hospital mortality.

See this image and copyright information in PMC

References

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Characteristics and Clinical Outcomes of Critically Ill Cancer Patients Admitted to Korean Intensive Care Units

Affiliations

Characteristics and Clinical Outcomes of Critically Ill Cancer Patients Admitted to Korean Intensive Care Units

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources

Miscellaneous