Prevalence of cancer patients in German intensive care units
Prevalence of cancer patients in German intensive care units
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DOI：
10.1007/s00063-019-0594-3
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发表时间：
2020-05-01
影响因子：
1.1
通讯作者：
Boell, B.
中科院分区：
文献类型：
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作者：
Kochanek, M.;Shimabukuro-Vornhagen, A.;Boell, B.
简介 癌症是全世界导致死亡的主要原因之一。由于合并症、年龄和积极化疗的增加，癌症患者在重症监护病房 (ICU) 中的护理变得越来越必要。到目前为止，人们对德国 ICU 癌症患者的护理结构知之甚少。这项工作的目的是收集和评估两个参考日期癌症患者的患病率和护理数据。方法邀请德国 ICU 参与一项为期 2 天、前瞻性、多中心点的 ICU 癌症患者患病率研究。参与该研究是自愿的，并且该研究没有资助。进行这项研究需要进行伦理投票。参与中心将数据匿名输入 eCRF（电子病例报告表）。因此无法识别患者身份。 结果 ICU/IMC 病房中大约四分之一的患者患有血液肿瘤 (HO) 疾病（n = 316/1319，24%）。这一比例很大程度上取决于每家医院的床位数量。入住 ICU/IMC 站最常见的原因是术后监测（n = 83/221，37.6%）、呼吸不稳定（n = 79/221，35.7%）、循环不稳定（n = 52/221；23.5%）和脓毒症严重感染（n = 47/221；21.3%）。总的来说，66.5% (n = 147/221) 的患者患有实体瘤，21.7% (n = 48/221) 患有血液癌症，78.3% (n = 173/221) 记录的癌症患者接受了“全码”强化管理，而 42.5% (n = 94/221) 的 HO 患者接受了通气和40.7% (n = 90/221) 需要儿茶酚胺。中位（平均值；IQR）SAPS II 评分为 35（37.79，IQR = 24-48），中位（平均值，IQR = 24-48）TISS 评分为 10（13.26，IQR = 10-15）。 总结 通过对患病率研究中可用数据的分析和评估，首次可以确定德国范围内血液癌症患者的跨中心患病率和护理情况在重症监护室和中间护理站。德国 ICU 和 IMC 病房中大约四分之一的患者被诊断为严重或轻微癌症 (n = 316/1319 = 24%)。该患者群体的护理管理很复杂，需要密切的跨学科合作。
Introduction Cancer is one of the leading causes of death worldwide. Due to increasing comorbidities, age and aggressive chemotherapy, care of cancer patients in intensive care units (ICUs) is more and more necessary. So far, little is known about the care structure of cancer patients in German ICUs. The aim of this work is to collect and evaluate the prevalence and care data of cancer patients on two reference dates.Methods German ICUs were invited to participate in a 2-day, prospective, multicenter point prevalence study in ICU cancer patients. Participation in the study was voluntary and the study was not funded. An ethics vote was obtained to conduct the study. The data were anonymously entered into an eCRF (electronic case report form) by the participating centers. Identification of the patients is therefore not possible.Results About one in four patients on the ICU/IMC ward had hematological-oncological (HO) disease (n = 316/1319, 24%). The proportion depended significantly on the number of beds in each hospital. The most frequent reasons for admission to the ICU/IMC station were postoperative monitoring (n = 83/221, 37.6%), respiratory instability (n = 79/221, 35.7%), circulatory instability (n = 52/221; 23.5%) and the severe infection with sepsis (n = 47/221; 21.3%). In all, 66.5% (n = 147/221) of the patients had a solid tumor and 21.7% (n = 48/221) had hematological cancer, 78.3% (n = 173/221) of the documented cancer patients received "full-code" intensive management, while 42.5% (n = 94/221) of the HO patients were ventilated and 40.7% (n = 90/221) required catecholamines. The median (mean; IQR) SAPS II score was 35 (37.79, IQR = 24-48) and the median (mean, IQR) TISS score was 10 (13.26, IQR = 10-15).Summary Through the analysis and evaluation of the data available in the context of the prevalence study, it was possible for the first time to determine the Germany-wide cross-center prevalence and care situation of hematological cancer patients in intensive care and intermediate care stations. About one in four patients on German ICUs and IMC wards have a major or minor cancer diagnosis (n = 316/1319 = 24%). Care management is complex in this patient population and requires close interdisciplinary collaboration.