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Multicenter Study
. 2023 Dec 15;13(1):22340.
doi: 10.1038/s41598-023-49219-6.

Prognostic and risk factor analysis of cancer patients after unplanned ICU admission: a real-world multicenter study

Miao Wei  1 , Mingguang Huang  2 , Yan Duan  1 , Donghao Wang  3 , Xuezhong Xing  4 , Rongxi Quan  5 , Guoxing Zhang  6 , Kaizhong Liu  7 , Biao Zhu  8 , Yong Ye  9 , Dongmin Zhou  10 , Jianghong Zhao  11 , Gang Ma  12 , Zhengying Jiang  13 , Bing Huang  14 , Shanling Xu  15 , Yun Xiao  16 , Linlin Zhang  17 , Hongzhi Wang  18 , Ruiyun Lin  19 , Shuliang Ma  20 , Yu'an Qiu  21 , Changsong Wang  22 , Zhen Zheng  23 , Ni Sun  24 , Lewu Xian  25 , Ji Li  26 , Ming Zhang  27 , Zhijun Guo  28 , Yong Tao  29 , Li Zhang  30 , Xiangzhe Zhou  31 , Wei Chen  32 , Daoxie Wang  33 , Jiyan Chi  34
Affiliations
Multicenter Study

Prognostic and risk factor analysis of cancer patients after unplanned ICU admission: a real-world multicenter study

Miao Wei et al. Sci Rep. .

Abstract

To investigate the occurrence and 90-day mortality of cancer patients following unplanned admission to the intensive care unit (ICU), as well as to develop a risk prediction model for their 90-day prognosis. We prospectively analyzed data from cancer patients who were admitted to the ICU without prior planning within the past 7 days, specifically between May 12, 2021, and July 12, 2021. The patients were grouped based on their 90-day survival status, and the aim was to identify the risk factors influencing their survival status. A total of 1488 cases were included in the study, with an average age of 63.2 ± 12.4 years. The most common reason for ICU admission was sepsis (n = 940, 63.2%). During their ICU stay, 29.7% of patients required vasoactive drug support (n = 442), 39.8% needed invasive mechanical ventilation support (n = 592), and 82 patients (5.5%) received renal replacement therapy. We conducted a multivariate COX proportional hazards model analysis, which revealed that BMI and a history of hypertension were protective factors. On the other hand, antitumor treatment within the 3 months prior to admission, transfer from the emergency department, general ward, or external hospital, high APACHE score, diagnosis of shock and respiratory failure, receiving invasive ventilation, and experiencing acute kidney injury (AKI) were identified as risk factors for poor prognosis within 90 days after ICU admission. The average length of stay in the ICU was 4 days, while the hospital stay duration was 18 days. A total of 415 patients died within 90 days after ICU admission, resulting in a mortality rate of 27.9%. We selected 8 indicators to construct the predictive model, which demonstrated good discrimination and calibration. The prognosis of cancer patients who are unplanned transferred to the ICU is generally poor. Assessing the risk factors and developing a risk prediction model for these patients can play a significant role in evaluating their prognosis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow diagram of the case collection.
Figure 2
Figure 2
Variables selection using the BSR.
Figure 3
Figure 3
Nomogram of the 90-day prognosis of patients with unplanned ICU transfer.
Figure 4
Figure 4
Probability calibration of model-predicted 90-day survival versus actual survival in patients with unplanned ICU transfer.
See this image and copyright information in PMC

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