Medicina · 2026
[Predictors of mortality and post-discharge quality of life in critically ill cancer patients].
СтатьяНаблюдательное исследованиеАннотация на английскомНазвание и аннотация: Перевод пока не подготовлен
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Rodríguez Victoria, Diaz-Ballve Ladislao P, Peralta B Leticia, Loiacono Flavia, Magnifico Lorena, Llerena-Concari Sofía, Sagardia Judith
Аннотация
INTRODUCTION: The number of patients with cancer requiring intensive care is increasing. Critical illness and post-intensive care unit (ICU) syndrome may impair post-discharge recovery and quality of life. This study aimed to analyze ICU mortality, identify associated prognostic factors, and evaluate health-related quality of life after discharge in critically ill cancer patients.
MATERIALS AND METHODS: A prospective, observational, single-center cohort study was conducted including adults with oncologic disease admitted to a mixed ICU of a public hospital between 2021 and 2022. Clinical characteristics, illness severity, organ support, complications, and therapeutic adequacy were recorded. Quality of life was assessed at hospital discharge and at three months using the EQ-5D-3L instrument. Bivariate analyses and multivariable logistic regression were performed.
RESULTS: A total of 204 patients with cancer were included. ICU mortality was 41.7%, and in-hospital mortality reached 53.4%. Independent predictors of ICU mortality were hospital length of stay before ICU admission, invasive mechanical ventilation, septic shock, higher SAPS II scores, and COVID-19 at admission. All EQ-5D-3L dimensions were impaired at discharge; at three months, only mobility and self-care improved. A substantial proportion of survivors did not resume oncologic therapy.
CONCLUSION: Mortality was primarily driven by critical illness severity and the impact of COVID-19. Partial recovery of quality of life and difficulties in resuming cancer-directed treatment highlight the need to reinforce post-ICU follow-up and targeted rehabilitation in this vulnerable population.
MATERIALS AND METHODS: A prospective, observational, single-center cohort study was conducted including adults with oncologic disease admitted to a mixed ICU of a public hospital between 2021 and 2022. Clinical characteristics, illness severity, organ support, complications, and therapeutic adequacy were recorded. Quality of life was assessed at hospital discharge and at three months using the EQ-5D-3L instrument. Bivariate analyses and multivariable logistic regression were performed.
RESULTS: A total of 204 patients with cancer were included. ICU mortality was 41.7%, and in-hospital mortality reached 53.4%. Independent predictors of ICU mortality were hospital length of stay before ICU admission, invasive mechanical ventilation, septic shock, higher SAPS II scores, and COVID-19 at admission. All EQ-5D-3L dimensions were impaired at discharge; at three months, only mobility and self-care improved. A substantial proportion of survivors did not resume oncologic therapy.
CONCLUSION: Mortality was primarily driven by critical illness severity and the impact of COVID-19. Partial recovery of quality of life and difficulties in resuming cancer-directed treatment highlight the need to reinforce post-ICU follow-up and targeted rehabilitation in this vulnerable population.