Hacettepe Üniversitesi Tıp Fakültesi Onkoloji Yoğun Bakım Ünitesine Yatan Hastaların Genel Özelliklerinin İncelenmesi ve Yatış Kriterlerine Göre Prognoz Değerlendirilmesi

Abstract

ABSTRACT Haziyev T. Investigation of general characteristics of patients admitted to Hacettepe University Faculty of Medicine oncology intensive care unit and evaluation of the prognosis according to the admission criteria. Internal Medicine Specialty Training Thesis, ANKARA, 2017. Along with the increase in the life span of cancer patients, the need for intensive care has also increased. Today, with the expectation of increased survival, new prognostic factors should be identified for admission of oncology patients to intensive care units. There are various suggestions in the literature regarding prognosis prediction and admission priority criteria. We aimed to investigate the relationship between modified admission criteria with 28-day mortality in patients admitted to the oncology intensive care unit (OICU) in our study. Patients who were admitted to OICU between 1.10.2013-31.3.2016 were retrospectively classified according to 3 admission priority criteria as "full support", "intensive care trial" and "no indication for admission" and the patients were compared according to these criteria. A total of 306 critically ill cancer patients were admitted. 181 (59%) of the patients were male, median minimum-maximum age was 60 19-93 and APACHE II score was 23.1 5-47. The first day SOFA score was 7.0 0-19. Solid cancer was present in 67% of the patients (n = 206). Mechanical ventilation was performed in 235 patients (76.8%). 28-day mortality was 46.7%, intensive care mortality was 51.0% and hospital mortality was 66.7%. Fifty nine point two percent of the patients were admitted as "full support", 15.0% as "intensive care trial" and 25.8% as "no indication for admission". The 28-day mortality rate was lowest in “full support” group and highest in “no indication for admission group” (37.6%, 52.2%, 64.6% respectively, p = 0.0001) with similar results in hospital mortality rate (59.1%, 76.1%, 78.5% respectively, p = 0.004). In logistic regression analysis, high lactate level and SOFA score, presence of solid cancer and ‘‘no indication for admission’' criteria were asssociated with 28-day mortality. In conclusion, admission priority criteria, defined as "full support", "intensive care trial" and "no indication for admission" in critically ill patients with cancer can be used for mortality prediction.