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What is the outcome of cancer patients admitted to the ICU after cardiac arrest? Results from a multicenter study.

Abstract：

AIM:Low survival rate was previously described after cardiac arrest in cancer patients and may challenge the appropriateness of intensive care unit (ICU) admission after return of spontaneous circulation (ROSC). Objectives of this study were to report outcome and characteristics of cancer patients admitted to the ICU after cardiac arrest. METHODS:A retrospective chart review in seven medical ICUs in France, in 2002-2012. We studied consecutive patients with malignancies admitted after out-of-hospital cardiac arrest (OHCA) or in-hospital cardiac arrest (IHCA). RESULTS:Of 133 included patients of whom 61% had solid tumors, 48 (36%) experienced OHCA and 85 (64%) IHCA. Cardiac arrest was related to the malignancy or its treatment in 47% of patients. Therapeutic hypothermia was used in 51 (41%) patients. The ICU mortality rate was 98/133 (74%). Main causes of ICU death were refractory shock or multiple organ failure (n = 64, 48%) and neurological injury (n = 27, 20%); 42 (32%) patients died in ICU after treatment-limitation decisions. Twenty-four (18%) patients were discharged alive from the hospital. Overall 6-month survival rate was 14% (18/133, 95% confidence interval, 8-21%). Survival rates at ICU discharge and after 6 months did not differ significantly across type of malignancy or between the OHCA and IHCA groups, and neither were they significantly different from those in matched controls who had cardiac arrest but no malignancy. CONCLUSIONS:Even if low, the 6-month survival rate of 14% observed in cancer patients admitted to the ICU after cardiac arrest and ROSC may support the admission of these patients to the ICU and may warrant an initial full-code ICU management.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Champigneulle B,Merceron S,Lemiale V,Geri G,Mokart D,Bruneel F,Vincent F,Perez P,Mayaux J,Cariou A,Azoulay E

doi

10.1016/j.resuscitation.2015.04.011

subject

Has Abstract

pub_date

2015-07-01 00:00:00

pages

38-44

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(15)00164-1

journal_volume

92

pub_type

杂志文章,多中心研究

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