Abstract：
OBJECTIVE:To evaluate the impact of two different comorbidity measures on the 6-month mortality of severely ill cancer patients. DESIGN AND SETTING:Prospective cohort study in a ten-bed oncological medical-surgical intensive care unit (ICU). PATIENTS:A total of 772 consecutive patients were included over a 45-month period. The mean age was 57.6+/-16.4 years, and 642 (83%) patients had solid tumors. MEASUREMENTS AND RESULTS:Data were collected on admission and during ICU stay. Comorbidities were evaluated using the Charlson Comorbidity Index (CCI) and the Adult Comorbidity Evaluation (ACE-27). The ICU, hospital, and 6-month mortality rates were 34%, 47%, and 58%, respectively. The most frequent comorbidities were hypertension (33%), diabetes mellitus (8%), and chronic pulmonary disease (7%). There were important differences between the two indices regarding the comorbidity evaluation. Using the ACE-27, 389 patients (50%) had comorbid ailments that were classified as mild (31%), moderate (14%), and severe (5%) according to the comorbidity severity. According to the CCI, 212 patients (27%) had a comorbidity, and their median score was 1 (1-2). In the multivariable Cox proportional hazard models only the presence of a severe comorbidity by the ACE-27 was associated with increased mortality. The CCI was not independently associated with the outcome. Other outcome predictors were older age, poor performance status, active cancer, need of mechanical ventilation, and severity of acute organ failures. CONCLUSIONS:Severe comorbidities must be considered in the outcome evaluation of ICU cancer patients. The ACE-27 seems to be a useful instrument for prognostic assessment in this population.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Soares M,Salluh JI,Ferreira CG,Luiz RR,Spector N,Rocco JRdoi
10.1007/s00134-005-2554-zkeywords:
subject
Has Abstractpub_date
2005-03-01 00:00:00pages
408-15issue
3eissn
0342-4642issn
1432-1238journal_volume
31pub_type
杂志文章abstract：OBJECTIVE:Pressure-volume (PV) curves are recorded after induction of complete muscle paralysis, which may limit their clinical use. The feasibility of recording PV curves without paralysis has not been tested. In 19 patients with acute respiratory distress syndrome (ARDS) and no hemodynamic instability we prospectivel...
journal_title：Intensive care medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00134-006-0265-8
更新日期：2006-09-01 00:00:00
abstract：PURPOSE:Hypoxia-ischemia (HI), as a major cause of fetal brain damage, has long-lasting neurological implications. Therefore, therapeutic interventions that attenuate the neuropathological outcome of HI while also improving the neurofunctional outcome are of paramount clinical importance. The aim of this study was to i...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-010-1913-6
更新日期：2010-09-01 00:00:00
abstract：OBJECTIVE:To assess the effects of intravenous fish oil fat emulsion on the metabolic alterations induced by lipopolysaccharide (LPS) challenge in healthy volunteers. DESIGN:Two groups of eight healthy subjects were randomized to receive either two pharmacological doses of intravenous FO fat emulsion or no treatment. ...
journal_title：Intensive care medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00134-007-0591-5
更新日期：2007-05-01 00:00:00
abstract：OBJECTIVE:To describe the incidence, risk factors, and impact on mortality of acute kidney injury (AKI) in patients with 2009 influenza A (H1N1) viral pneumonia requiring mechanical ventilation. DESIGN:Observational cohort study. PATIENTS AND METHODS:AKI was defined as risk, injury or failure, according to the RIFLE ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-011-2167-7
更新日期：2011-05-01 00:00:00
abstract：OBJECTIVE:To assess procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations and clearance in nonseptic end-stage renal failure patients undergoing their first three hemodialysis sessions. DESIGN AND SETTING:Prospective observational consecutive clinical study at a university hospital. PATIENTS:The stud...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-1664-8
更新日期：2003-04-01 00:00:00
abstract：OBJECTIVE:To evaluate clinical and microbiologic characteristics, modalities of treatment and outcome of patients with cervical necrotizing fasciitis admitted to our institution. DESIGN:Retrospective clinical investigation. PATIENTS AND METHODS:We reviewed the charts of 20 consecutive patients hospitalized in our Int...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340050959
更新日期：1999-08-01 00:00:00
abstract：:Meta-analyses and several large cohort studies have demonstrated that antiseptic mouthwashes are associated with mortality in hospitalized patients. A clear pathogenic mechanism is lacking, leading to controversy and a reluctance to abandon or limit the use of antiseptic mouthwashes. Here, we generate the hypothesis t...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-020-06276-z
更新日期：2021-01-01 00:00:00
abstract：OBJECTIVE:To assess the prevalence of relative adrenal insufficiency in patients successfully resuscitated after cardiac arrest, and its prognostic role in post-resuscitation disease. DESIGN AND SETTING:A prospective observational single-center study in a medical intensive care unit. PATIENTS:64 patients hospitalised...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-005-2603-7
更新日期：2005-05-01 00:00:00
abstract：OBJECTIVE:To determine the incidence rates of hospital acquired infections (HAI) during the first 14 days after ICU discharge after treatment during ICU-stay with Selective Decontamination of the Digestive tract (SDD), Selective Oropharyngeal Decontamination (SOD) or Standard Care (SC). DESIGN:Prospective observationa...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1554-9
更新日期：2009-09-01 00:00:00
abstract：OBJECTIVE:To investigate whether serum procalcitonin (PCT) levels could be useful to differentiate between systemic infection and the activity of the underlying disease in autoimmune disease. METHODS:In 18 patients with systemic lupus erythematodes (SLE) and 35 patients with systemic antineutrophil cytoplasmic antibod...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF02900738
更新日期：2000-03-01 00:00:00
abstract：PURPOSE:To examine the association of intravenous iodinated contrast material administration with the subsequent development of post-contrast AKI (PC-AKI), emergent dialysis, and short-term mortality using a propensity score-adjusted analysis of a cohort of intensive care unit (ICU) patients who underwent CT examinatio...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-017-4699-y
更新日期：2017-06-01 00:00:00
abstract：OBJECTIVE:To identify factors associated with mortality and prolonged ventilatory requirements in patients admitted to our paediatric intensive care unit (PICU) with tracheobronchial malacia and stenosis diagnosed by dynamic contrast bronchograms. DESIGN:Retrospective review. SETTING:Tertiary paediatric intensive car...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340000822
更新日期：2001-04-01 00:00:00
abstract：:Conventional indices of tissue perfusion after surgery involving cardiopulmonary bypass (CPB) may not accurately reflect disordered cell metabolism. Venous hypercarbia leading to an increased veno-arterial difference in CO2 tensions (V-aCO2 gradient) has been shown to reflect critical reductions in systemic and pulmon...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01716189
更新日期：1991-01-01 00:00:00
abstract：:A young woman with long-standing systemic lupus erythematosus and rheumatic fever presented with deteriorating renal function. She had severe gastritis treated with cimetidine and received methylprednisolone when her blood cultures were repeatedly negative. She developed spontaneous bruising and bleeding from venepunc...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01724803
更新日期：1990-01-01 00:00:00
abstract：:There has been little research on smoking cessation after critical illness. Smokers make up a high percentage of patients admitted to intensive care (ICU) and stopping smoking is one message that should be clearly given to recovering patients. The recovery period provides an important opportunity for patients to quit ...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s001340101051
更新日期：2001-09-01 00:00:00
abstract：OBJECTIVE:To investigate the accuracy of lung ultrasonography (LUS) in the quantification of lung water in critically ill patients by using quantitative computed tomography (CT) as the gold standard for the determination of lung weight. METHODS:Twenty consecutive patients admitted to an intensive care unit who underwe...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-012-2694-x
更新日期：2013-01-01 00:00:00
abstract：OBJECTIVE:To evaluate the influence of changes in alveolar ventilation on the following tonometry-derived variables: gastric intramucosal CO2 tension (PtCO2), gastric arterial CO2 tension difference (PgapCO2), gastric intramucosal pH (pHi) and arterial pH-pHi difference (pHgap). DESIGN:Clinical prospective study. SET...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/s001340050834
更新日期：1999-03-01 00:00:00
abstract：:Nine patients hospitalized for tetanus were studied under the same protocol which included two haemodynamic studies with a preload trial (PLT). The first being made during therapy (diazepam barbiturate association), on the sixth day of hospitalisation, and the second one after recovery. The comparison of the results s...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01700252
更新日期：1978-07-01 00:00:00
abstract：PURPOSE:Reporting neurodevelopmental outcome of 8-year-old children treated with neonatal extracorporeal membrane oxygenation (ECMO). METHODS:In a follow-up study in 135 8-year-old children who received neonatal ECMO between 1996 and 2001 we assessed intelligence (Revised Amsterdam Intelligence Test), concentration (B...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s00134-013-2973-1
更新日期：2013-09-01 00:00:00
abstract：OBJECTIVE:We assessed the methodological trial quality of individual randomized controlled studies on chlorhexidine silver sulfadiazine impregnated catheters and the effect on catheter-related infection (CRI). DESIGN:Only the studies identified in the Medline database from 1966 to December 2001 were considered, abstra...
journal_title：Intensive care medicine
pub_type： 杂志文章,meta分析
doi：10.1007/s00134-003-1646-x
更新日期：2003-03-01 00:00:00
abstract：OBJECTIVE:To clarify the effects of hypercapnia (increased PaCO2) on gastric mucosal oxygenation during anaesthesia in dogs. DESIGN:Prospective, controlled animal study. SETTING:Experimental research laboratory of an university hospital. SUBJECTS:Six chronically instrumented dogs. INTERVENTIONS:Dogs were anaestheti...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-008-1183-8
更新日期：2008-10-01 00:00:00
abstract：PURPOSE:We assessed outcomes in brain-injured patients after implementation of a multi-faceted approach to reduce respiratory complications in intensive care units. METHODS:Prospective nationwide before-after trial. Consecutive adults with acute brain injury requiring mechanical ventilation for ≥24 h in 20 French inte...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s00134-017-4764-6
更新日期：2017-07-01 00:00:00
abstract：OBJECTIVE:The immediate overwhelming release of inflammatory mediators in septic shock is rapidly followed by strong anti-inflammatory responses inducing a state of immunosuppression. The patients who survive the initial hyper-inflammatory step of septic shock but subsequently die may be those who do not recover from i...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-006-0204-8
更新日期：2006-08-01 00:00:00
abstract：:Acute renal failure in critically ill patients is seldom an isolated problem but is more usually associated with multiple organ failure. When choosing an extracorporeal kidney replacement therapy, these other failing organs must be taken into account. Therefore the choice of an artificial kidney in patients requiring ...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/BF00261492
更新日期：1989-01-01 00:00:00
abstract：OBJECTIVE:Short-latency somatosensory evoked potential (SSEP) monitoring has been reported to be useful in predicting neurological outcome in patients with cardiac arrest and hypoxic-ischemic encephalopathy. To obtain the immediate data of SSEP and evaluate the relationship between the presence of cortical activity and...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340100984
更新日期：2001-07-01 00:00:00
abstract：OBJECTIVE:Pulmonary endothelial activation caused by high pulmonary capillary pressures may be involved in the pathogenesis of cardiogenic pulmonary edema (CPE). We studied soluble selectins and soluble ICAM-1 as markers of cell activation in the systemic and pulmonary circulation of patients with respiratory failure (...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340000843
更新日期：2001-03-01 00:00:00
abstract：OBJECTIVE:To determine: (1) the proportion of small (<5 mm) or thrombosed internal jugular veins (IJV) and femoral veins (FV) in which catheter placement would be difficult without ultrasound guidance; (2) which position increases central vein sizes and may facilitate cannulation of these vessels. DESIGN:Prospective s...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-007-0875-9
更新日期：2008-02-01 00:00:00
abstract：PURPOSE:To determine incidence, risk factors and outcome of tracheal ischemic lesions related to intubation. METHODS:Planned post hoc analysis using patients from a previous randomized controlled study. Fiberoptic tracheoscopy was performed during the 24 h following extubation. In patients with >2 ischemic lesions, ul...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-012-2750-6
更新日期：2013-04-01 00:00:00
abstract：OBJECTIVE:To compare the total plasma cortisol values obtained from three widely used immunoassays and a high pressure liquid chromatography (HPLC) technique on samples obtained from patients with sepsis. DESIGN AND SETTING:Observational interventional in the general intensive care unit of a metropolitan hospital PAT...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-006-0389-x
更新日期：2006-11-01 00:00:00
abstract：:Total extracorporeal lung assist (ECLA) requires a bypass flow approaching cardiac output. Recirculation of venous blood through the oxygenator is minimized with a veno-right ventricular cannulation technique which separates venous drainage from returned oxygenated blood. A case of posttraumatic ARDS was treated with ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01691426
更新日期：1991-01-01 00:00:00
